Early Catheter Removal after Radical Retropubic Prostatectomy

Kang, Taejin; Hong, Bumsik; Ahn, Hanjong

Abstract

PURPOSE: There is a trend towards early catheter removal after radical retropubic prostatectomy (RRP). Therefore, the feasibility of early catheter removal after RRP was explored.
MATERIALS AND METHODS
Twenty-four consecutive patients having undergone a RRP performed by one surgeon were divided into two groups. Groups A and B comprised the patients who had their cystography taken either 6 or 14 days after surgery, respectively. Voiding symptoms in the immediate (after catheter removal) and late postoperative (1 month after catheter removal) periods were assessed. The mean patient ages were 68.8, ranging from 59 to 76 and 66.8, ranging from 61 to 73 years in groups A and B (p=0.37), respectively. The Mean follow-up was 4.3 months (1-9).
RESULTS
One patient in each group showed significant urine leakage on cystography, which required a further week of catheter indwelling. In group A, 8 patients (72.7%) needed pads for their incontinence immediately after catheter removal and 3 (27.3%) required pads continuously 1 month after catheter removal. In group B, incontinence that required pads developed in 9 patients (81.8%) immediately after catheter removal, and in 3 (27.3%) 1 month after catheter removal. One patient in group A required a 3-day Foley catheter indwelling for urinary retention. There were 4 (36.4%) and 2 (18.2%) patients in groups A and B, respectively, with weak urinary stream (Qmax<15ml/sec).
CONCLUSIONS
A catheter can be safely removed, with caution, 6 days after a radical retropubic prostatectomy for the development of urinary retention and weak stream, which might be caused by anastomotic edema and transiently decreased bladder contractility.