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Open Access 01-12-2015 | Research article

Comparison of continence outcomes of early catheter removal on postoperative day 2 and 4 after laparoscopic radical prostatectomy: a randomized controlled trial

Authors: Masashi Matsushima, Akira Miyajima, Seiya Hattori, Toshikazu Takeda, Ryuichi Mizuno, Eiji Kikuchi, Mototsugu Oya

Published in: BMC Urology | Issue 1/2015

Abstract

Background

The optimal timing of catheter removal following laparoscopic radical prostatectomy (LRP) has not yet been determined. This prospective study was designed to compare the efficacy and safety of catheter removal on postoperative day (POD) 2 versus POD 4 after LRP and its impact on urinary continence outcomes.

Methods

One hundred and thirteen patients underwent LRP and were prospectively randomized into two groups: group 1 (n = 57) had the urinary catheter removed on POD 2 while group 2 (n = 56) had the catheter removed on POD 4. The urine loss ratio (ULR) was defined as the weight of urine loss in the pad divided by the daily micturition volume. Continence was defined as a pad-free status.

Results

No significant differences were observed in clinical features between groups 1 and 2. Acute urinary retention (AUR) after catheter removal occurred in 21 patients (18.6 %) (13 (22.8 %) in group 1 and 8 (14.3 %) in group 2 (p = 0.244). The first-day mean ULR values were 1.16 ± 4.95 in group 1 and 1.02 ± 3.27 in group 2 (p = 0.870). The last-day mean ULR values were 0.57 ± 1.60 in group 1 and 2.78 ± 15.49 in group 2 (p = 0.353). Continence rates at 3, 6, 9, and 12 months were 21.8, 41.1, 58.0, and 71.4 % in group 1 and 34.5, 66.0, 79.2, and 83.7 % in group 2 (p = 0.138, 0.009, 0.024, and 0.146, respectively). In AUR cases, continence rates at 3, 6, 9, and 12 months were 0, 23.1, 38.5, and 54.5 % in group 1 and 37.5, 75.0, 87.5, and 87.5 % in group 2 (p = 0.017, 0.020, 0.027, and 0.127, respectively). A multivariate analysis identified AUR after catheter removal on POD 2 as the only predictive factor for incontinence 6 and 9 months after LRP (p = 0.030 and 0.018, respectively).

Conclusions

Our results demonstrated that early catheter removal on POD 2 after LRP may increase the risk of incontinence.

Trial registration

The study was registered as Clinical trial: (UMIN000014944); registration date: 12 March 2012.

Shelfo SW, Obek C, Soloway MS. Update on bladder neck preservation during radical retropubic prostatectomy: impact on pathologic outcome, anastomotic strictures, and continence. Urology. 1998;51(1):73–8.PubMedCrossRef

Murphy GP, Mettlin C, Menck H, Winchester DP, Davidson AM. National patterns of prostate cancer treatment by radical prostatectomy: results of a survey by the American College of Surgeons Commission on Cancer. J Urol. 1994;152(5 Pt 2):1817–9.PubMed

Steiner MS, Morton RA, Walsh PC. Impact of anatomical radical prostatectomy on urinary continence. J Urol. 1991;145(3):512–4. discussion 514–515.PubMed

Lepor H, Nieder AM, Fraiman MC. Early removal of urinary catheter after radical retropubic prostatectomy is both feasible and desirable. Urology. 2001;58(3):425–9.PubMedCrossRef

Koch MO, Nayee AH, Sloan J, Gardner T, Wahle GR, Bihrle R, et al. Early catheter removal after radical retropubic prostatectomy: long-term followup. J Urol. 2003;169(6):2170–2.PubMedCrossRef

Lau KO, Cheng C. Feasibility of early catheter removal after radical retropubic prostatectomy. Tech Urol. 2001;7(1):38–40.PubMed

Souto CA, Teloken C, Souto JC, Rhoden EL, Ting HY. Experience with early catheter removal after radical retropubic prostatectomy. J Urol. 2000;163(3):865–6.PubMedCrossRef

Schuessler WW, Schulam PG, Clayman RV, Kavoussi LR. Laparoscopic radical prostatectomy: initial short-term experience. Urology. 1997;50(6):854–7.PubMedCrossRef

Guillonneau B, Cathelineau X, Barret E, Rozet F, Vallancien G. Laparoscopic radical prostatectomy: technical and early oncological assessment of 40 operations. Eur Urol. 1999;36(1):14–20.PubMedCrossRef

10.

Hoznek A, Menard Y, Salomon L, Abbou CC. Update on laparoscopic and robotic radical prostatectomy. Curr Opin Urol. 2005;15(3):173–80.PubMedCrossRef

11.

Nadu A, Salomon L, Hoznek A, Olsson LE, Saint F, de La Taille A, et al. Early removal of the catheter after laparoscopic radical prostatectomy. J Urol. 2001;166(5):1662–4.PubMedCrossRef

12.

Ficarra V, Novara G, Artibani W, Cestari A, Galfano A, Graefen M, et al. Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a systematic review and cumulative analysis of comparative studies. Eur Urol. 2009;55(5):1037–63.PubMedCrossRef

13.

Ates M, Teber D, Gozen AS, Tefekli A, Hruza M, Sugiono M, et al. A new postoperative predictor of time to urinary continence after laparoscopic radical prostatectomy: the urine loss ratio. Eur Urol. 2007;52(1):178–85.PubMedCrossRef

14.

Sato Y, Tanda H, Nakajima H, Nitta T, Akagashi K, Hanzawa T, et al. Simple and reliable predictor of urinary continence after radical prostatectomy: serial measurement of urine loss ratio after catheter removal. Int J Urol. 2014;21(7):647–51.PubMedCrossRef

15.

Van Kampen M, Geraerts I, De Weerdt W, Van Poppel H. An easy prediction of urinary incontinence duration after retropubic radical prostatectomy based on urine loss the first day after catheter withdrawal. J Urol. 2009;181(6):2641–6.PubMedCrossRef

16.

Rocco F, Carmignani L, Acquati P, Gadda F, Dell’Orto P, Rocco B, et al. Early continence recovery after open radical prostatectomy with restoration of the posterior aspect of the rhabdosphincter. Eur Urol. 2007;52(2):376–83.PubMedCrossRef

17.

Agarwal PK, Sammon J, Bhandari A, Dabaja A, Diaz M, Dusik-Fenton S, et al. Safety profile of robot-assisted radical prostatectomy: a standardized report of complications in 3317 patients. Eur Urol. 2011;59(5):684–98.PubMedCrossRef

18.

Coelho RF, Chauhan S, Orvieto MA, Sivaraman A, Palmer KJ, Coughlin G, et al. Influence of modified posterior reconstruction of the rhabdosphincter on early recovery of continence and anastomotic leakage rates after robot-assisted radical prostatectomy. Eur Urol. 2011;59(1):72–80.PubMedCrossRef

19.

Joshi N, de Blok W, van Muilekom E, van der Poel H. Impact of posterior musculofascial reconstruction on early continence after robot-assisted laparoscopic radical prostatectomy: results of a prospective parallel group trial. Eur Urol. 2010;58(1):84–9.PubMedCrossRef

20.

Dalton DP, Schaeffer AJ, Garnett JE, Grayhack JT. Radiographic assessment of the vesicourethral anastomosis directing early decatheterization following nerve-sparing radical retropubic prostatectomy. J Urol. 1989;141(1):79–81.PubMed

21.

Leibovitch I, Rowland RG, Little Jr JS, Foster RS, Bihrle R, Donohue JP. Cystography after radical retropubic prostatectomy: clinical implications of abnormal findings. Urology. 1995;46(1):78–80.PubMedCrossRef

22.

Palisaar JR, Roghmann F, Brock M, Loppenberg B, Noldus J, von Bodman C: Predictors of short-term recovery of urinary continence after radical prostatectomy. World J Urol 2014. doi:10.1007/s00345-014-1340-3

23.

Tiguert R, Rigaud J, Fradet Y. Safety and outcome of early catheter removal after radical retropubic prostatectomy. Urology. 2004;63(3):513–7.PubMedCrossRef

24.

Bhayani SB, Pavlovich CP, Hsu TS, Sullivan W, Su L. Prospective comparison of short-term convalescence: laparoscopic radical prostatectomy versus open radical retropubic prostatectomy. Urology. 2003;61(3):612–6.PubMedCrossRef

25.

Patel R, Lepor H. Removal of urinary catheter on postoperative day 3 or 4 after radical retropubic prostatectomy. Urology. 2003;61(1):156–60.PubMedCrossRef

26.

Noguchi M, Shimada A, Yahara J, Suekane S, Noda S. Early catheter removal 3 days after radical retropubic prostatectomy. Int J Urol. 2004;11(11):983–8.PubMedCrossRef

27.

Borboroglu PG, Sands JP, Roberts JL, Amling CL. Risk factors for vesicourethral anastomotic stricture after radical prostatectomy. Urology. 2000;56(1):96–100.PubMedCrossRef

28.

Park R, Martin S, Goldberg JD, Lepor H. Anastomotic strictures following radical prostatectomy: insights into incidence, effectiveness of intervention, effect on continence, and factors predisposing to occurrence. Urology. 2001;57(4):742–6.PubMedCrossRef

29.

Tomschi W, Suster G, Holtl W. Bladder neck strictures after radical retropubic prostatectomy: still an unsolved problem. Br J Urol. 1998;81(6):823–6.PubMedCrossRef

30.

Ficarra V, Novara G, Rosen RC, Artibani W, Carroll PR, Costello A, et al. Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy. Eur Urol. 2012;62(3):405–17.PubMedCrossRef

Title: Comparison of continence outcomes of early catheter removal on postoperative day 2 and 4 after laparoscopic radical prostatectomy: a randomized controlled trial
Authors: Masashi Matsushima
Akira Miyajima
Seiya Hattori
Toshikazu Takeda
Ryuichi Mizuno
Eiji Kikuchi
Mototsugu Oya
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: BMC Urology / Issue 1/2015
Electronic ISSN: 1471-2490
DOI: https://doi.org/10.1186/s12894-015-0065-y

ACC 2024 Congress

Springer Medicine

Comparison of continence outcomes of early catheter removal on postoperative day 2 and 4 after laparoscopic radical prostatectomy: a randomized controlled trial

Abstract

Background

Methods

Results

Conclusions

Trial registration

ACC 2024 Congress

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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