Muhammad Zubair Afzal1, Conrad M Tobert2, Emi Bulica2, Sabrina L Noyes3, Brian R Lane4. 1. Division of Urology, Spectrum Health Hospital System, Grand Rapids, MI; Grand Rapids Medical Education Partners, Grand Rapids, MI. 2. Grand Rapids Medical Education Partners, Grand Rapids, MI; Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, MI. 3. Division of Urology, Spectrum Health Hospital System, Grand Rapids, MI. 4. Division of Urology, Spectrum Health Hospital System, Grand Rapids, MI; Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, MI. Electronic address: brian.lane@spectrumhealth.org.
Abstract
OBJECTIVE: To compare the outcomes of patients undergoing robot-assisted radical prostatectomy (RARP) with urinary drainage using a modified technique for suprapubic catheter (SPC) placement with those undergoing a previously described technique for SPC placement and those with urethral catheter (UC) alone. MATERIALS AND METHODS: We reviewed the records of 225 consecutive patients who underwent RARP by a single surgeon. The most recent patients were contacted via a telephone survey with 86 responses (69%) received. RESULTS: After RARP, 174 patients had only UC placement (77%) and 51 had an SPC placed (23%). Twelve patients had SPC placement with a 4-mL balloon (SPC-4), with catheter-related complications occurring in four patients (33%). The technique was modified to use SPC with a 10-mL balloon (SPC-10). Only 2 of 39 SPC-10 patients (5%) had catheter-related complications (P = .03 vs SPC-4). Continence rates at 6 weeks were 83% and 82% for UC and SPC, respectively. Based on postoperative survey results using a 10-point scale, overall experience with RARP was rated 8.9 ± 1.7 and 8.7 ± 2.3 for UC and SPC, respectively (P = .63). Mean catheter bother was rated 5.1 ± 3.0 and 4.6 ± 2.9 for UC and SPC, respectively (P = .45). CONCLUSION: SPC provides a safe option for patients who would prefer not to have UC following RARP, with equivalent perioperative outcomes. Modification of the published technique to place a standard 16F catheter results in fewer catheter-related complications.
OBJECTIVE: To compare the outcomes of patients undergoing robot-assisted radical prostatectomy (RARP) with urinary drainage using a modified technique for suprapubic catheter (SPC) placement with those undergoing a previously described technique for SPC placement and those with urethral catheter (UC) alone. MATERIALS AND METHODS: We reviewed the records of 225 consecutive patients who underwent RARP by a single surgeon. The most recent patients were contacted via a telephone survey with 86 responses (69%) received. RESULTS: After RARP, 174 patients had only UC placement (77%) and 51 had an SPC placed (23%). Twelve patients had SPC placement with a 4-mL balloon (SPC-4), with catheter-related complications occurring in four patients (33%). The technique was modified to use SPC with a 10-mL balloon (SPC-10). Only 2 of 39 SPC-10 patients (5%) had catheter-related complications (P = .03 vs SPC-4). Continence rates at 6 weeks were 83% and 82% for UC and SPC, respectively. Based on postoperative survey results using a 10-point scale, overall experience with RARP was rated 8.9 ± 1.7 and 8.7 ± 2.3 for UC and SPC, respectively (P = .63). Mean catheter bother was rated 5.1 ± 3.0 and 4.6 ± 2.9 for UC and SPC, respectively (P = .45). CONCLUSION: SPC provides a safe option for patients who would prefer not to have UC following RARP, with equivalent perioperative outcomes. Modification of the published technique to place a standard 16F catheter results in fewer catheter-related complications.