Suprapubic tube versus urethral catheter drainage after robot-assisted radical prostatectomy: a systematic review and meta-analysis

Abstract

BackgroundProstate cancer is one of the most common cancers in the elderly population. The standard treatment is radical prostatectomy (RARP). However, urologists do not have consents on the postoperative urine drainage management (suprapubic tube (ST)/ urethral catheter (UC)). Thus, we try to compare ST drainage to UC drainage after robot-assisted radical prostatectomy regarding to comfort, recovery rate and continence using the method of meta-analysis.MethodsA systematic search was performed in Dec. 2017 on PubMed, Medline, Embase and Cochrane Library databases. The authors independently reviewed the records to identify studies comparing ST with UC of patients underwent RARP. Meta-analysis was performed using the extracted data from the selected studies.ResultsSeven studies, including 3 RCTs, with a total of 946 patients met the inclusion criteria and were included in our meta-analysis. Though there was no significant difference between the ST group and the UC group on postoperative pain (RR1.73, P 0.20), our study showed a significant improvement on bother or discomfort, defined as trouble in hygiene and sleep, caused by catheter when compared two groups at postoperative day (POD) 7 in ST group (RR2.05, P 0.006). There was no significant difference between the ST group and UC group on urinary continence (RR0.98, P 0.74) and emergency department visit (RR0.61, P 0.11). The rates of bladder neck contracture and other complications were very low in both groups.ConclusionCompared to UC, ST showed a weak advantage. So it might be a good choice to choose ST over RARP.

<p>Surgical Management of Urolithiasis of the Upper Tract – Current Trend of Endourology in Africa</p>

“…A systematic review by Zumstein et al of 61 member states of the Societé Internationale d’Urologie (SIU) found no guidelines for urolithiasis amongst Sub-Saharan states. 8 …”

“…The surgical management of kidney and ureteral stones is based on the stone location, size, the patient’s preference and the institutional capacity. 8 Over past decades, there has been a paradigm shift from open surgery to endourology in the management of upper tract urolithiasis. To date, the available modalities in the management of urolithiasis include external shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), ureterorenoscopy (URS) including flexible and semirigid ureteroscopy.…”

Premature MicroRNA-Based Therapeutic: A “One-Two Punch” against Cancers

“…The combined effect of miR-17-5p/3p led to a proliferative and migratory phenotype [ 73 ]. Additional examples include oncogenic pre-miR-10b in esophageal squamous cell carcinoma (ESCC) [ 74 , 75 ], pre-miR-21 in ovarian cancer [ 98 , 99 , 100 ], and pre-miR-221 in PCa [ 76 , 77 ], the dual tumor-promoting strands in all these cases have been identified by individual studies. First, starvation-induced miR-10b-5p expression increased the autophagic flux in ESCC during nutrient deprivation, and DAZ associated protein 1 ( DAZAP1 ) was the direct target and mediator of this phenomenon.…”

“…MiR-221-5p expression was elevated in tumor and adjacent tissues of clinical samples, indicating its oncogenic role in prostate carcinogenesis. Ectopic miR-221-5p manipulation proved that miR-221-5p enhanced the migratory and proliferative capabilities of PCa cells in vitro, and suppressers of cytokine signaling 1 ( SOCS1 ), an established tumor suppressor, was validated to be the direct target of 3’-UTR luciferase reporter assay [ 76 ]. MiR-221-3p is reported to participate in the development or maintenance of castration resistant prostate cancer (CRPC) phenotype, but the underlying mechanism remains unknown [ 105 ].…”

Anatomical, surgical and technical factors influencing continence after radical prostatectomy

“…Suprapubic tube placement, therefore, is not routinely recommended for urine drainage after a RP. 61…”