Early catheter removal after radical retropubic prostatectomy: Long-term followup

Michael Koch, Anish H. Nayee, James Sloan, Thomas Gardner, Greg R. Wahle, Richard Bihrle, Richard Foster

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Purpose: We examine the complication and continence rates with early catheter removal (day 3 or 4) after radical retropubic prostatectomy. Materials and Methods: A total of 365 patients with localized prostate cancer underwent radical retropubic prostatectomy at Indiana University Hospital with planned urethral catheter removal before discharge home. Low pressure cystograms were performed on postoperative day 3 or 4 to determine if catheter removal was possible. A subset of patients were analyzed using a validated prostate cancer specific questionnaire (University of California, Los Angeles Prostate Cancer Symptom Index) to determine quality of life outcomes. Results: The catheter was removed on postoperative day 3 or 4 in 263 patients (72%). The reasons for leaving the catheter indwelling were significant leak on cystogram or excessive suprapubic drainage (21%), extensive bladder neck reconstruction (1%) and prolonged hospitalization because of an ileus or other complicating factor (6%). Thirteen patients (3.6%) were either unable to void after catheter removal or presented with retention (not associated with hematuria or clots) after hospital discharge, requiring reinsertion of the Foley catheter. A total of 41 patients (11%) had either an early or late complication (excluding incontinence). There were 3 complications (0.8%) that were considered major because they were potentially life threatening or required a return to the operating room. A pelvic abscess developed in 2 patients and a lymphocele in 1, which required percutaneous drainage. After at least 6 months (mean 20.9 months) 140 patients (89.2%) and 14 (8.9%) reported excellent and good continence, respectively. The patient questionnaire demonstrated bother scores to be minimal to no bother for 95% to 98% of patients at 6 and 12 months. Conclusions: This study confirms that it is safe to remove catheters in most patients 3 to 4 days after prostatectomy if a cystogram demonstrates no extravasation. Complication rates and continence rates with this approach compare favorably with series in which catheters are left indwelling for longer periods.

Original languageEnglish
Pages (from-to)2170-2172
Number of pages3
JournalJournal of Urology
Volume169
Issue number6
DOIs
StatePublished - Jun 1 2003

Fingerprint

Prostatectomy
Catheters
Prostatic Neoplasms
Indwelling Catheters
Drainage
Lymphocele
Urinary Catheters
Los Angeles
Ileus
Hematuria
Operating Rooms
Abscess
Urinary Bladder
Hospitalization
Quality of Life
Pressure

Keywords

  • Catheterization
  • Device removal
  • Prostatectomy

ASJC Scopus subject areas

  • Urology

Cite this

Early catheter removal after radical retropubic prostatectomy : Long-term followup. / Koch, Michael; Nayee, Anish H.; Sloan, James; Gardner, Thomas; Wahle, Greg R.; Bihrle, Richard; Foster, Richard.

In: Journal of Urology, Vol. 169, No. 6, 01.06.2003, p. 2170-2172.

Research output: Contribution to journalArticle

@article{dd7c51fe2ae6489b859124c5de5b350e,
title = "Early catheter removal after radical retropubic prostatectomy: Long-term followup",
abstract = "Purpose: We examine the complication and continence rates with early catheter removal (day 3 or 4) after radical retropubic prostatectomy. Materials and Methods: A total of 365 patients with localized prostate cancer underwent radical retropubic prostatectomy at Indiana University Hospital with planned urethral catheter removal before discharge home. Low pressure cystograms were performed on postoperative day 3 or 4 to determine if catheter removal was possible. A subset of patients were analyzed using a validated prostate cancer specific questionnaire (University of California, Los Angeles Prostate Cancer Symptom Index) to determine quality of life outcomes. Results: The catheter was removed on postoperative day 3 or 4 in 263 patients (72{\%}). The reasons for leaving the catheter indwelling were significant leak on cystogram or excessive suprapubic drainage (21{\%}), extensive bladder neck reconstruction (1{\%}) and prolonged hospitalization because of an ileus or other complicating factor (6{\%}). Thirteen patients (3.6{\%}) were either unable to void after catheter removal or presented with retention (not associated with hematuria or clots) after hospital discharge, requiring reinsertion of the Foley catheter. A total of 41 patients (11{\%}) had either an early or late complication (excluding incontinence). There were 3 complications (0.8{\%}) that were considered major because they were potentially life threatening or required a return to the operating room. A pelvic abscess developed in 2 patients and a lymphocele in 1, which required percutaneous drainage. After at least 6 months (mean 20.9 months) 140 patients (89.2{\%}) and 14 (8.9{\%}) reported excellent and good continence, respectively. The patient questionnaire demonstrated bother scores to be minimal to no bother for 95{\%} to 98{\%} of patients at 6 and 12 months. Conclusions: This study confirms that it is safe to remove catheters in most patients 3 to 4 days after prostatectomy if a cystogram demonstrates no extravasation. Complication rates and continence rates with this approach compare favorably with series in which catheters are left indwelling for longer periods.",
keywords = "Catheterization, Device removal, Prostatectomy",
author = "Michael Koch and Nayee, {Anish H.} and James Sloan and Thomas Gardner and Wahle, {Greg R.} and Richard Bihrle and Richard Foster",
year = "2003",
month = "6",
day = "1",
doi = "10.1097/01.ju.0000065860.16392.19",
language = "English",
volume = "169",
pages = "2170--2172",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - Early catheter removal after radical retropubic prostatectomy

T2 - Long-term followup

AU - Koch, Michael

AU - Nayee, Anish H.

AU - Sloan, James

AU - Gardner, Thomas

AU - Wahle, Greg R.

AU - Bihrle, Richard

AU - Foster, Richard

PY - 2003/6/1

Y1 - 2003/6/1

N2 - Purpose: We examine the complication and continence rates with early catheter removal (day 3 or 4) after radical retropubic prostatectomy. Materials and Methods: A total of 365 patients with localized prostate cancer underwent radical retropubic prostatectomy at Indiana University Hospital with planned urethral catheter removal before discharge home. Low pressure cystograms were performed on postoperative day 3 or 4 to determine if catheter removal was possible. A subset of patients were analyzed using a validated prostate cancer specific questionnaire (University of California, Los Angeles Prostate Cancer Symptom Index) to determine quality of life outcomes. Results: The catheter was removed on postoperative day 3 or 4 in 263 patients (72%). The reasons for leaving the catheter indwelling were significant leak on cystogram or excessive suprapubic drainage (21%), extensive bladder neck reconstruction (1%) and prolonged hospitalization because of an ileus or other complicating factor (6%). Thirteen patients (3.6%) were either unable to void after catheter removal or presented with retention (not associated with hematuria or clots) after hospital discharge, requiring reinsertion of the Foley catheter. A total of 41 patients (11%) had either an early or late complication (excluding incontinence). There were 3 complications (0.8%) that were considered major because they were potentially life threatening or required a return to the operating room. A pelvic abscess developed in 2 patients and a lymphocele in 1, which required percutaneous drainage. After at least 6 months (mean 20.9 months) 140 patients (89.2%) and 14 (8.9%) reported excellent and good continence, respectively. The patient questionnaire demonstrated bother scores to be minimal to no bother for 95% to 98% of patients at 6 and 12 months. Conclusions: This study confirms that it is safe to remove catheters in most patients 3 to 4 days after prostatectomy if a cystogram demonstrates no extravasation. Complication rates and continence rates with this approach compare favorably with series in which catheters are left indwelling for longer periods.

AB - Purpose: We examine the complication and continence rates with early catheter removal (day 3 or 4) after radical retropubic prostatectomy. Materials and Methods: A total of 365 patients with localized prostate cancer underwent radical retropubic prostatectomy at Indiana University Hospital with planned urethral catheter removal before discharge home. Low pressure cystograms were performed on postoperative day 3 or 4 to determine if catheter removal was possible. A subset of patients were analyzed using a validated prostate cancer specific questionnaire (University of California, Los Angeles Prostate Cancer Symptom Index) to determine quality of life outcomes. Results: The catheter was removed on postoperative day 3 or 4 in 263 patients (72%). The reasons for leaving the catheter indwelling were significant leak on cystogram or excessive suprapubic drainage (21%), extensive bladder neck reconstruction (1%) and prolonged hospitalization because of an ileus or other complicating factor (6%). Thirteen patients (3.6%) were either unable to void after catheter removal or presented with retention (not associated with hematuria or clots) after hospital discharge, requiring reinsertion of the Foley catheter. A total of 41 patients (11%) had either an early or late complication (excluding incontinence). There were 3 complications (0.8%) that were considered major because they were potentially life threatening or required a return to the operating room. A pelvic abscess developed in 2 patients and a lymphocele in 1, which required percutaneous drainage. After at least 6 months (mean 20.9 months) 140 patients (89.2%) and 14 (8.9%) reported excellent and good continence, respectively. The patient questionnaire demonstrated bother scores to be minimal to no bother for 95% to 98% of patients at 6 and 12 months. Conclusions: This study confirms that it is safe to remove catheters in most patients 3 to 4 days after prostatectomy if a cystogram demonstrates no extravasation. Complication rates and continence rates with this approach compare favorably with series in which catheters are left indwelling for longer periods.

KW - Catheterization

KW - Device removal

KW - Prostatectomy

UR - http://www.scopus.com/inward/record.url?scp=0037611190&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037611190&partnerID=8YFLogxK

U2 - 10.1097/01.ju.0000065860.16392.19

DO - 10.1097/01.ju.0000065860.16392.19

M3 - Article

C2 - 12771741

AN - SCOPUS:0037611190

VL - 169

SP - 2170

EP - 2172

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 6

ER -