Risk Factors for Failure of Early Catheter Removal After Greenlight HPS Laser Photoselective Vaporization Prostatectomy in Men With Benign Prostatic Hyperplasia

Abstract

PurposeTo assess the risk factors for developing urinary retention after removal of the urethral catheter on postoperative day 1 in benign prostatic hyperplasia patients who underwent Greenlight HPS laser photoselective vaporization prostatectomy (PVP).Materials and MethodsThe study included 427 men who underwent Greenlight HPS laser PVP between 2009 and 2012, excluding patients in whom a catheter was maintained for more than 1 day because of urethral procedures. In all patients, a voiding trial was performed on postoperative day 1; if patients were unable to urinate, the urethral catheter was replaced before hospital discharge. The patients were divided into two groups: early catheter removal (postoperative day 1) and late catheter removal (urethral catheter reinsertion). Preoperative and perioperative parameters were compared between the groups.ResultsCatheters were successfully removed in 378 (88.6%) patients on postoperative day 1. In 49 patients, the catheters were reinserted and removed a mean of 6.45±0.39 days after surgery. In a multivariate analysis, a history of diabetes was the most significant predictor (p=0.028) of failure of early catheter removal, followed by operative time (p=0.039). There were no significant differences in age, prostate volume, International Prostate Symptom Score, or urodynamic parameters between the two groups.ConclusionsIt is feasible, safe, and cost-effective to remove the urethral catheter on postoperative day 1 after Greenlight HPS laser PVP, but the procedure should be done carefully in patients who have history of diabetes or an extended operative time.

Outcome of Early Removal of Urinary Catheter after Transurethral Resection of Prostate (TUR-P)

“…The mean IPSS was 34.69 ± 1.34 with a p-value of 0.710. Comparing with the study of Bae WJ et al, their mean IPSS was 21.45 ± 0.54 23 ; it is believed that severe IPSS was because of the severe dysuria felt by the patient in their earlier voids. Despite an improved caliber of urinary stream the patient felt hesitant to void post early catheter removal.…”

Effect of saline perfusion before catheter removal in patients with benign prostatic hyperplasia treated with GreenLight laser photoselective vaporization of the prostate

“…; P = 0.012]; however, the anxiety level before PVP surgery was not signi cantly different between the groups (3 [3][4] vs. 3 [3][4], P = 0.140]. In addition, urinalysis revealed that the WBC count in the perfusion group was signi cantly lower than that in the control group on the day [25.5(8-37.75) vs. 43.5(24.0-64.75); P < 0.001] and 2 weeks [20.5 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27) vs 31.0(20-42); P < 0.001] after catheter removal (Table 4). All postoperative complications that occurred during the 6-month follow-up period are summarized in Table 5.…”

“…Although surgical clinical outcomes of PVP have been con rmed worldwide, the time of catheter removal after PVP is inconclusive [12], and saline perfusion before catheter removal has not yet been reported. Patients treated with PVP usually require catheterization for 1-9 days, which is determined by the patient and PVP surgery.…”

Vaporization techniques for benign prostatic obstruction

“…Bae et al [13] conducted a consecutive cohort study with a total of 427 patients treated with HPS and tried to determine the risk factors responsible…”