The impact of time to catheter removal on short-, intermediate- and long-term urinary continence after radical prostatectomy
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To assess the impact of prolonged catheterization time on 1-week (short-term), 3-month (intermediate-term) and 1-year (long-term) UC.
Between 2008 and 2015, 6918 men underwent RP by four high-volume surgeons. Exclusion criteria were baseline urinary incontinence (UI) and radiotherapy prior or within 12 months after RP. For the remaining 4111 patients, data on short-, intermediate- and long-term UC were available for 3989, 2490 and 1967 patients, respectively. UC was defined as the use of zero or 1-safety pad/24 h. Time to catheter removal was categorized into ≤ 7, 8–14 and ≥ 15 days. To assess the impact of catheterization time on short-, intermediate- and long-term UI, uni- and multivariable logistic regression analyses adjusted for age, BMI, prostate volume, pathological tumor stage, Charlson comorbidity index and nerve-sparing technique were performed.
Post-RP UC rates at 1 week for catheterization of ≤ 7, 8–14 and ≥ 15 days were 31.2, 27.4 and 18.0%. For the same groups, 3-month and 1-year UC rates were 82.7, 79.2 and 74.1% as well as 90.8, 91.6 and 88.2%, respectively. In multivariate logistic regressions, longer catheterization time was associated with worse short- and intermediate UI (OR 15 days: 2.19 and 1.54; p = ≤ 0.001 and p = 0.04). This difference dissipated at 1 year after RP (p > 0.05).
While longer catheterization is associated with worse short- and intermediate-term UC, it has no adverse impact on long-term UC.
KeywordsProstate cancer Radical prostatectomy Urinary continence Catheter removal Catheterization
DT: protocol/project development, data collection or management, data analysis, and manuscript writing/editing. FP: data collection or management, data analysis, and manuscript writing/editing. PK: protocol/project development, data analysis, and manuscript writing/editing. SFS: protocol/project development and manuscript writing/editing. MG: protocol/project development, data collection or management, and manuscript writing/editing. HH: protocol/project development, data collection or management, and manuscript writing/editing. FKC: protocol/project development, data collection or management, and manuscript writing/editing. RSP: protocol/project development, data collection or management, data analysis, and manuscript writing/editing.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Statement of human rights
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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