Skip to main content
Log in

Suprapubic Versus Urethral Catheter for Urinary Drainage After Robot-Assisted Radical Prostatectomy

  • Endourology (P Mucksavage and BK Somani, Section Editors)
  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To review the evidence regarding the usage of suprapubic tube (SPT) versus indwelling urethral catheter (IUC) after robot-assisted radical prostatectomy (RARP).

Recent Findings

Available data on the use of SPT for urinary drainage after RARP is somewhat limited mostly because of the variations of study designs and non-standardized outcomes. Although it may provide some mild benefit in terms of catheter-related pain and discomfort, the benefit seems not to be clinically significant.

Summary

The evidence in the literature so far does not support routine usage of SPT as the primary urinary drainage method after RARP. Further higher-quality studies that can show clinically significant advantages over IUC are still needed to justify its usage.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69(1):7–34.

    Article  Google Scholar 

  2. Navaratnam A, Abdul-Muhsin H, Humphreys M. Updates in Urologic Robot Assisted Surgery. F1000Res. 2018;7:F1000.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Gratzke C, Dovey Z, Novara G, Geurts N, de Groote R, Schatteman P, et al. Early catheter removal after robot-assisted radical prostatectomy: surgical technique and outcomes for the Aalst technique (ECaRemA study). Eur Urol. 2016;69(5):917–23.

    Article  PubMed  Google Scholar 

  4. Lista G, et al. Early catheter removal after robot-assisted radical prostatectomy: results from a prospective single-institutional randomized trial (ripreca study). Eur Urol Focus. 2020;6(2):259–66.

  5. Zegerman A, Ezri T, Weinbroum AA. Postoperative discomfort (other than pain) - a neglected feature of postanesthesia patient care. J Clin Monit Comput. 2008;22(4):279–84.

    Article  PubMed  Google Scholar 

  6. Woldu SL, Weinberg AC, Bergman A, Shapiro EY, Korets R, Motamedinia P, et al. Pain and analgesic use after robot-assisted radical prostatectomy. J Endourol. 2014;28(5):544–8.

    Article  PubMed  Google Scholar 

  7. •• Harke N, et al. Postoperative patient comfort in suprapubic drainage versus transurethral catheterization following robot-assisted radical prostatectomy: a prospective randomized clinical trial. World J Urol. 2017;35(3):389–94 RCT showing suprapubic drainage significantly decreased pain levels compared to urethral drainage without compromising long-term functional results.

    Article  PubMed  Google Scholar 

  8. •• Martinschek A, et al. Transurethral versus suprapubic catheter at robot-assisted radical prostatectomy: a prospective randomized trial with 1-year follow-up. World J Urol. 2016;34(3):407–11 RCT showing patients with suprapubic tube were significantly less bothered by the catheter at personal and genital hygiene compared to urethral catheter.

    Article  CAS  PubMed  Google Scholar 

  9. •• Prasad SM, et al. Early removal of urethral catheter with suprapubic tube drainage versus urethral catheter drainage alone after robot-assisted laparoscopic radical prostatectomy. J Urol. 2014;192(1):89–95 RCT showing suprapubic tube provided no benefits in terms pain, catheter related bother and treatment related satisfaction in the perioperative period compared to urethral catheter.

    Article  PubMed  Google Scholar 

  10. Galfano A, et al. Pain and discomfort after Retzius-sparing robot-assisted radical prostatectomy: a comparative study between suprapubic cystostomy and urethral catheter as urinary drainage. Minerva Urol Nefrol. 2019;71(4):381–5.

    Article  PubMed  Google Scholar 

  11. Morgan MS, et al. An assessment of patient comfort and morbidity after robot-assisted radical prostatectomy with suprapubic tube versus urethral catheter drainage. J Endourol. 2016;30(3):300–5.

    Article  PubMed  Google Scholar 

  12. Yang C-J, Ou Y-C, Yang C-K. Percutaneous cystostomy drainage for early removing urethral catheter in robotic-assisted laparoscopic radical prostatectomy: improving on patients’ discomfort. Urol Sci. 2015;26(4):240–2.

    Article  Google Scholar 

  13. Afzal MZ, Tobert CM, Bulica E, Noyes SL, Lane BR. Modification of technique for suprapubic catheter placement after robot-assisted radical prostatectomy reduces catheter-associated complications. Urology. 2015;86(2):401–6.

    Article  PubMed  Google Scholar 

  14. Krane LS, Bhandari M, Peabody JO, Menon M. Impact of percutaneous suprapubic tube drainage on patient discomfort after radical prostatectomy. Eur Urol. 2009;56(2):325–30.

    Article  PubMed  Google Scholar 

  15. Tewari A, Rao S, Mandhani A. Catheter-less robotic radical prostatectomy using a custom-made synchronous anastomotic splint and vesical urinary diversion device: report of the initial series and perioperative outcomes. BJU Int. 2008;102(8):1000–4.

    Article  PubMed  Google Scholar 

  16. Sammon JD, Trinh QD, Sukumar S, Diaz M, Simone A, Kaul S, et al. Long-term follow-up of patients undergoing percutaneous suprapubic tube drainage after robot-assisted radical prostatectomy (RARP). BJU Int. 2012;110(4):580–5.

    Article  PubMed  Google Scholar 

  17. Ghani KR, Trinh QD, Sammon JD, Jeong W, Simone A, Dabaja A, et al. Percutaneous suprapubic tube bladder drainage after robot-assisted radical prostatectomy: a step-by-step guide. BJU Int. 2013;112(5):703–5.

    Article  PubMed  Google Scholar 

  18. Sammon JD, Sharma P, Trinh QD, Ghani KR, Sukumar S, Menon M. Predictors of immediate continence following robot-assisted radical prostatectomy. J Endourol. 2013;27(4):442–6.

    Article  PubMed  Google Scholar 

  19. Sun Y, et al. Suprapubic catheter: the replacement of conventional urethral catheter after robot-assisted laparoscopic prostatectomy. J Modern Urol. 2018;8:600–4.

    Google Scholar 

  20. Li MX, Cheng P, Yao L, Li HJ, Xun YQ, Yan PJ, et al. Suprapubic tube compared with urethral catheter drainage after robot-assisted radical prostatectomy: a systematic review and meta-analysis. Asian J Surg. 2019;42(1):71–80.

    Article  PubMed  Google Scholar 

  21. Jian Z, Feng S, Chen Y, Wei X, Luo D, Li H, et al. Suprapubic tube versus urethral catheter drainage after robot-assisted radical prostatectomy: a systematic review and meta-analysis. BMC Urol. 2018;18(1):1.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Hwang EC, Risk MC, Dahm P. Suprapubic versus urethral catheter drainage in robotic-assisted laparoscopic prostatectomy: advancing systematic review quality. World J Urol. 2018;36(9):1501–2.

    Article  PubMed  Google Scholar 

  23. Bertolo R, Tracey A, Dasgupta P, Rocco B, Micali S, Bianchi G, et al. Supra-pubic versus urethral catheter after robot-assisted radical prostatectomy: systematic review of current evidence. World J Urol. 2018;36(9):1365–72.

    Article  PubMed  Google Scholar 

  24. Fantus RJ, Cohen A, Riedinger CB, Kuchta K, Wang CH, Yao K, et al. Facility-level analysis of robot utilization across disciplines in the National Cancer Database. J Robot Surg. 2019;13(2):293–9.

    Article  PubMed  Google Scholar 

  25. Lee DJ, Ding J, Guzzo TJ. Improving operating room efficiency. Curr Urol Rep. 2019;20(6):28.

    Article  PubMed  Google Scholar 

  26. Kersten P, White PJ, Tennant A. Is the pain visual analogue scale linear and responsive to change? An exploration using Rasch analysis. PLoS One. 2014;9(6):e99485.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Riemann BL, Lininger M. Statistical primer for athletic trainers: the difference between statistical and clinical meaningfulness. J Athl Train. 2015;50(12):1223–5.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Webb DR, Sethi K, Gee K. An analysis of the causes of bladder neck contracture after open and robot-assisted laparoscopic radical prostatectomy. BJU Int. 2009;103(7):957–63.

    Article  PubMed  Google Scholar 

  29. Montorsi F, Wilson TG, Rosen RC, Ahlering TE, Artibani W, Carroll PR, et al. Best practices in robot-assisted radical prostatectomy: recommendations of the Pasadena Consensus Panel. Eur Urol. 2012;62(3):368–81.

    Article  PubMed  Google Scholar 

  30. Breyer BN, Davis CB, Cowan JE, Kane CJ, Carroll PR. Incidence of bladder neck contracture after robot-assisted laparoscopic and open radical prostatectomy. BJU Int. 2010;106(11):1734–8.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Prasad SM, Smith ND, Catalona WJ, Sammon J, Menon M. Suprapubic tube after radical prostatectomy. J Urol. 2013;189(6):2028–30.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Leilei Xia.

Ethics declarations

Conflict of Interest

No potential conflicts of interest from any authors.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Endourology

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Xia, L., Guzzo, T.J., Mucksavage, P. et al. Suprapubic Versus Urethral Catheter for Urinary Drainage After Robot-Assisted Radical Prostatectomy. Curr Urol Rep 21, 30 (2020). https://doi.org/10.1007/s11934-020-00982-3

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11934-020-00982-3

Keywords

Navigation