Early Removal of the Catheter After Laparoscopic Radical Prostatectomy

Nadu, Andrei; Salomon, Laurent; Hoznek, Andràs; Olsson, Leif Eric; Saint, F.; Taille, Alexandre de la; Cicco, Antony; Chopin, Dominique; Abbou, Clément‐Claude

doi:10.1016/s0022-5347(05)65648-0

Cited by 111 publications

(68 citation statements)

References 8 publications

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“…Similar results were reported by Santis et al 13 who removed the catheter successfully 8 or 9 days after the surgery without cystography. Also, these results are to some extent supported by the study of Nadu et al , 7 who demonstrated in a large series of cases the absence of leaks in 84.9% of the individuals who underwent cystography 2 to 4 days after radical prostatectomy.…”

Section: Discussionsupporting

confidence: 63%

“…Also, it is our opinion that the cases of hematuria and urinary retention are acceptable events, since these can be easily solved by reposition of the catheter for longer periods. 6,7 In summary, considering some potentially limiting factors such as the relatively small size of the present series and the short period of follow-up, the results of the present study indicate that a period of 7 days of catheterization is probably enough after RRP, since catheter withdrawal after this period was not associated with a higher rate of complications than were experienced by the group of patients who had their catheters removed at the standard fashion (14 days after surgery).…”

Section: Discussionmentioning

confidence: 63%

“…6,8 Previous studies have demonstrated that early decatheterization after cystography was accompanied by an absence of leaks and could be performed safely and without significant complications. [8][9][10][11] Hewitt et al 12 demonstrated in perineal radical prostatectomies and, more recently, Nadu et al 7 demonstrated in a large series of laparoscopic radical prostatectomy that very early urethral catheter removal (4 days after surgery) was possible using gravitational cystography with an absence of leaks at the urethrovesical anastomosis. Nevertheless, it is important to note that cystography sometimes causes complications, and involves extra cost and can sometimes be an uncomfortable procedure.…”

Section: Discussionmentioning

confidence: 99%

“…6 Nadu et al 7 demonstrated that in 2 to 4 days after laparoscopic RRP, an absence of contrast leakage was ob-served in 84.9% of the patients, and that urethral catheter removal could be then safely performed.…”

mentioning

confidence: 99%

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Urethral catheter removal 7 or 14 days after radical retropubic prostatectomy: clinical implications and complications in a randomized study

Souto¹,

Rhoden²,

Conti³

et al. 2004

Rev. Hosp. Clin.

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PURPOSE:To evaluate the hypothesis that a 7-day period of indwelling catheter after radical retropubic prostatectomy is effective and safe without the need of performing cystography.METHODS: In the period from January of 2000 to July of 2002, 73 patients underwent radical retropubic prostatectomy, and these patients were prospectively randomized in 2 groups: Group 1-37 patients who had the urethral catheter removed 7 days after the procedure, and Group 2-36 patients who had the catheter removed 14 days after the surgery. The 2 groups were similar, the surgeons and the technique were the same, and no cystography was performed to evaluate the presence of leaks.RESULTS: Two patients in Group 1 had bleeding and clot retention after having the catheter taken out in the seventh postoperative day and were managed by putting the catheter back in for 7 more days. Two patients in Group 2 developed bladder neck stricture and were treated by bladder neck incision with success. The continence rate was the same, with 2 cases of incontinence in each group. About 2 pads a day were used by the patients with incontinence. The average follow-up was 17.5 months (12-36 months). No urinary fistula, urinoma, or pelvic abscesses developed after catheter removal. Two patients were excluded from the analysis of this series: 1 died with a pulmonary embolus in the third postoperative day, and 1 developed a urinary suprapubic fistula before catheter withdrawal, which was maintained for 16 days.CONCLUSION: Withdrawal of the urethral catheter 7 days after radical retropubic prostatectomy, without performing cystography, has a low rate of short-term complications that are equivalent to withdrawal 14 days after the surgery.

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Urethral catheter removal 7 or 14 days after radical retropubic prostatectomy: clinical implications and complications in a randomized study

Souto¹,

Rhoden²,

Conti³

et al. 2004

Rev. Hosp. Clin.

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“…Early recatheterization after radical prostatectomy (RP) is required in cases of acute urinary retention or disruption of vesicourethral anastomosis, after catheter removal, and in cases of incidental displacement of the catheter [1][2][3][4]. In addition, malfunction in draining the bladder requires immediate catheter replacement.…”

Section: Introductionmentioning

confidence: 99%

Transrectal ultrasound guidance for early transurethral recatheterization after radical prostatectomy

Raber

2014

J Ultrasound

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Purpose To study the usefulness of transrectal ultrasound (TRUS) for catheter guidance in cases of early reinsertion after radical prostatectomy (RP). Methods Since 2007, we have used TRUS for catheter guidance when early reinsertion after RP is required. A preliminary TRUS examination is done to carefully check the state of the vesicourethral anastomosis. The entire catheter insertion, from bulbar urethra to the bladder, is followed step by step by transrectal ultrasound imaging that tracks, while the probe pushes the catheter through a correct entering line. This prevents the incorrect placement of the catheter across the posterior aspect of the anastomosis in a posterior extravesical place. Results Between 2007 and 2011, 2,165 RPs were performed at reference hospital for prostate cancer. Early catheter reinsertion was required for 56 patients (2.6 %). All procedures were successful. The incidence of vesicourethral stricture after long-term follow-up was not different from that of patients without early recatheterization who were operated with RP in the same period of the study (4.4 vs 4.2 %, respectively; p = 0.47). Conclusions If early recatheterization is required in patients recently operated with RP, we suggest catheter guidance with TRUS.Keywords Ultrasonography Á Radical prostatectomy Á Anastomosis Á Urethral catheterization RiassuntoObiettivi lo studio della utilità della ecografia trans-rettale durante il posizionamento precoce del catetere vescicale nei pazienti operati di prostatectomia radicale. Metodi dal 2007 abbiamo introdotto la ecografia transrettale per la guida al posizionamento del catetere vescicale nei casi di cateterizzazione precoce dopo intervento di prostatectomia radicale. Il posizionamento del catetere vescicale viene monitorato durante il passaggio dalla uretra bulbare alla regione anastomotica e cervico-uretrale mentre la sonda stessa spinge il catetere verso l'alto in modo da imprimergli la progressione nella direzione della vescica. Questa azione ha lo scopo di impedire la progressione del catetere stesso, attraverso la parte posteriore dell'anastomosi ancora non consolidata, nello spazio extravescicale posteriore. Risultati tra il 2007 ed il 2011, sono state prese in considerazione 2,165 prostatectomie radicali realizzate presso un centro di riferimento per la patologia prostatica. La cateterizzazione precoce è stata necessaria in 56 pazienti (2.6 %). Tutte le procedure sono state portate a termine con successo. La incidenza della stenosi dell'anastomosi nel followup in questo gruppo di pazienti è risultata sovrapponibile a quella del gruppo di pazienti operati di prostatectomia radicale nello stesso periodo dello studio (4.4 vs 4.2 %, rispettivamente p = 0.47). Conclusioni nel caso di necessità di cateterismo precoce dopo intervento di prostatectomia radicale raccomandiamo l'impiego della ecografia trans-rettale per la guida al corretto posizionamento in vescica. Abbreviations TRUS Transrectal ultrasound RPRadical prostatectomy

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Policies for the removal of short-term indwelling urethral catheters

Griffiths

Fernandez²

2005

Cochrane Database of Systematic Reviews

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There is suggestive but inconclusive evidence of a benefit from midnight removal of the indwelling urethral catheter. There are resource implications but the magnitude of these is not clear from the trials. The evidence also suggests shorter hospital stay after early rather than delayed catheter removal but the effects on other outcomes are unclear. There is little evidence on which to judge other aspects of management, such as catheter clamping.

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Early Removal of the Catheter After Laparoscopic Radical Prostatectomy

Abstract: Patients who undergo laparoscopic radical prostatectomy can have the catheter safely removed 2 to 4 days postoperatively without a higher risk of incontinence, stricture or leak related problems.

Cited by 111 publications

References 8 publications

Urethral catheter removal 7 or 14 days after radical retropubic prostatectomy: clinical implications and complications in a randomized study

Urethral catheter removal 7 or 14 days after radical retropubic prostatectomy: clinical implications and complications in a randomized study

Transrectal ultrasound guidance for early transurethral recatheterization after radical prostatectomy

Policies for the removal of short-term indwelling urethral catheters

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