Removal of urinary catheter on postoperative day 3 or 4 after radical retropubic prostatectomy

Patel, Rahila; Lepor, Herbert

doi:10.1016/s0090-4295(02)02105-2

Cited by 72 publications

(48 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In case of development of AUR some investigators advised to reinsert the urinary catheter under cystoscopic guidance because of the potential risk of disruption of the vesicourethral anastomosis (VUA) and bladder neck reconstruction. 4 We believe that the utilization of robotic technology in prostatectomy has led to a better visualization and integrity of the VUA as all patients whom developed AUR in our series where treated with recatheterization on the word or emergency department with no difficulty and without the need of any adjuncts. None of the cases needed a urological input, and no one of the patients with AUR developed leak or another episode of AUR.…”

mentioning

confidence: 85%

“…2,3 Although leaving a temporary indwelling catheter is standard practice after radical prostatectomy to allow anastomotic healing, urinary catheterization represents a source of infection, significant discomfort, and anxiety for the patient following radical prostatectomy. 4 However, its placement for 7-14 days helps to avoid unwanted anastamotic urinary leakage and possible retention due to edema. The optimal time of catheter removal to avoid vesico-urethral anastomosis (VUA) leakage and prevent retention is unknown.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The risk of urinary retention following robot-assisted radical prostatectomy and its impact on early continence outcomes

Alnazari

Zanaty

Ajib

et al. 2017

CUAJ

View full text Add to dashboard Cite

Introduction: We aimed to evaluate the risk factors of acute urinary retention (AUR) following robot-assisted radical prostatectomy (RARP), as well as the relationship of AUR with early continence outcomes. Methods: The records of 740 consecutive patients who underwent RARP by two experienced surgeons at our institution were retrospectively reviewed from a prospectively collected database. Multiple factors, including age, body mass index (BMI), international prostate symptom score (IPSS), prostate volume, presence of median lobe, nerve preservation status, anastomosis time, and catheter removal time (Day 4 vs. 7), were evaluated as risk factors for AUR using univariate and multivariate analysis. The relation between AUR and early return of continence (one and three months) post-RARP was also evaluated. Results: The incidence of clinically significant vesico-urethral anastomotic (VUA) leak and AUR following catheter removal were 0.9% and 2.2% (17/740), respectively. In men who developed AUR, there was no significant relationship with regards to age, BMI, IPSS, prostatic volume, median lobe, nerve preservation, or anastomosis time; however, the incidence of AUR was significantly higher for men with catheter removal at Day 4 (4.5% [16/351]) vs. Day 7 (0.2% [1/389]) (p=0.004). Moreover, patients with early removal of the catheter (Day 4) who developed AUR had an earlier one-month return of 0-pad continence 87.5% (14/16) compared to patients without AUR 45.6% (153/335), with no significant difference at three months. Conclusions: While AUR is an uncommon complication of RARP, its incidence is much higher than VUA leakage. Further, it is often not well-discussed during patient counselling preoperatively. Moreover, earlier return of urinary continence was observed in patients experiencing AUR following RARP exclusively with catheter removal at Day 4. Future studies are warranted to validate the long-term impact of AUR on continence outcomes.

show abstract

mentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

The risk of urinary retention following robot-assisted radical prostatectomy and its impact on early continence outcomes

Alnazari

Zanaty

Ajib

et al. 2017

CUAJ

View full text Add to dashboard Cite

show abstract

“…In this initial number of patients we removed the catheter after 10 days although being aware of the accumulating reports of early catheter removal (20). Nevertheless, we must be aware that there are differences in the surgical technique and the number of sutures used for the VUA.…”

Section: Commentsmentioning

confidence: 99%

Reducing the number of sutures for vesicourethral anastomosis in radical retropubic prostatectomy

et al. 2009

View full text Add to dashboard Cite

Objectives: To prospectively evaluate the outcome of using a two-suture technique for the vesicourethral anastomosis (VUA) during radical retropubic prostatectomy (RRP). Materials and Methods: Two groups of 50 patients each underwent nerve-sparing RRP for localized prostate cancer by one surgeon. In one group, the vesicourethral anastomosis was performed using 2 Vicryl 2-0 stitches placed at the 3-and 9-o'clock positions and in the other group 6 Vicryl 2-0 stitches were placed at the 2-, 4-, 6-, 8-, 10-and 12-o'clock positions. The intraoperative and perioperative parameters analyzed were time to perform the VUA, time to remove the drain and hospitalization. The rate of incontinence, anastomotic stricture and erectile function were included in the outcome analysis. Results: The anastomotic time differed statistically between the 2 groups (mean 3.3 minutes for the 2-suture group and 10.5 minutes for the 6-suture group, p < 0.0001) with similar periods of drain removal (mean 3.12 days for the 2-suture group and 3.45 days for the 6-suture group; p = 0.13) and hospitalization (mean 4.66 days for the 2-suture group and 5.3 days for the 6-suture group; p = 0.09). The functional outcome was excellent for the 2-suture group with no patient suffering from incontinence or anastomotic strictures 1 year postoperatively, while in the 6-suture group there were 2 patients (4%) suffering from incontinence (2 underwent sling procedure) and 1 patient suffered from anastomotic stricture. Conclusion: The low number of sutures in the 2-suture VUA technique reduces operating times, does not influence perioperative and intraoperative parameters and results in excellent functional outcome.

show abstract

“…(14) Because of the high incidence of acute urinary retention requiring replacement of the urinary catheter and the potential for disruption of the anastomosis or bladder neck reconstruction, Patel R recommend delaying catheter removal until POD 7 or later. (15) In our study, patients who underwent TURP had an average duration of postoperative catheterisation of 3.4 days with a range of 2 -4 days and patients who underwent TUVP had an average duration of 2.8 days, whereas the average duration of catheterisation following open prostatectomy was significantly higher at 7.1 days (range of 6 -8 days).…”

Section: Discussionmentioning

confidence: 54%

A Comparative Study on the Outcomes of Various Modalities of Surgical Management of Benign Prostatic Hyperplasia

R¹,

A²,

Chandran³

2017

jemds

View full text Add to dashboard Cite

BACKGROUNDBenign prostatic hyperplasia is one of the most common ailments affecting elderly men. The lower urinary tract symptoms caused by it are distressing and cause significant morbidity. Most symptoms are manifested as derangement in urination due to the close anatomical relation between the bladder and the prostate.The present study was undertaken to study the surgical management of benign prostatic hyperplasia with emphasis on transurethral resection of prostate, transurethral vapourisation and open prostatectomy. MATERIALS AND METHODSThe study was a prospective hospital-based time-bound observational study conducted between December 2013 and May 2015 at a Medical College Hospital. RESULTSThe maximum incidence of the disease was in the age group of 61 -70 years. The next commonest mode of presentation was acute retention of urine followed by a weak stream. The average operating time for open prostatectomy was significantly higher. Urinary incontinence following minimally invasive procedures like TURP and TUVP was more common than following open prostatectomy. The average improvement in the symptoms of the patients who underwent TURP and TUVP for BPH at 3 months are similar and less when compared to open prostatectomy. CONCLUSIONTURP is the gold standard in the management of benign prostatic hyperplasia with earlier recovery and lesser postoperative complications. The lower urinary tract symptoms (LUTS) caused due to it are depressing and cause significant morbidity. These include obstructive or voiding symptoms and irritative or storage symptoms. Voiding symptoms include weak urinary stream, hesitancy, intermittency, dribbling and incomplete emptying. Storage symptoms include frequency, nocturia, urgency, urge incontinence and dysuria. The prevalence of LUTS in the male population increases with age and has been estimated to be 20% -25% for the middle-aged men and 40% -70% for men aged 70 years and above. (1,2) In 1992, The American Urological Association (AUA) published the Symptom Scoring Index, 'Financial or Other Competing Interest': None. Submission 17-07-2017, Peer Review 07-11-2017, Acceptance 14-11-2017, Published 20-11-2017. Corresponding Author: Dr. Aswathy Chandran, Room No. 49, Chetana Hostel, KIMS Campus, Hubli. E-mail: aswathydot@gmail.com DOI: 10.14260/jemds/2017/1387 which was adopted by the World Health Organisation in 1993 as the International Prostate Symptom Score (IPSS). It consists of seven questions referring to LUTS as in AUA symptom index with an additional question referring to quality of life. (3) The treatment of BPH has undergone a long development in the past two decades. Surgical modalities have undergone a revolutionary change with minimally invasive techniques, such as transurethral resection of prostate (TURP) becoming the mainstay of operative management with open surgery being reserved for larger glands associated with urethral stricture. Transurethral electrovaporisation of the prostate (TUVP) is a modification of the existing transurethral technolog...

show abstract

Removal of urinary catheter on postoperative day 3 or 4 after radical retropubic prostatectomy

Cited by 72 publications

References 10 publications

The risk of urinary retention following robot-assisted radical prostatectomy and its impact on early continence outcomes

The risk of urinary retention following robot-assisted radical prostatectomy and its impact on early continence outcomes

Reducing the number of sutures for vesicourethral anastomosis in radical retropubic prostatectomy

A Comparative Study on the Outcomes of Various Modalities of Surgical Management of Benign Prostatic Hyperplasia

Contact Info

Product

Resources

About