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Transurethral versus suprapubic catheter at robot-assisted radical prostatectomy: a prospective randomized trial with 1-year follow-up

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Abstract

Objective

To evaluate urethral catheter (UC) versus suprapubic tube (SPT) without stenting the anastomosis at robot-assisted radical prostatectomy (RALP) regarding surgical outcome and catheter-associated discomfort. One year after surgery, continence and patient satisfaction were evaluated.

Materials and methods

Sixty-two patients undergoing RALP were prospectively randomized to urinary drainage with UC or with SPT. Functional results were assessed with standardized questionnaires (IPSS, IPSS Bother Score, IIEF and Visual Analogue Scale) preoperatively, after catheter removal and 1 year after surgery. Moreover, bother by the catheter as well as pain due to the catheter was assessed.

Results

At personal hygiene, SPT was significantly less bothersome on the day of surgery as well as POD 1–6. Pain caused by the catheter did not differ significantly between the two groups except for POD 5 and 6, when the SPT performed significantly better. Differences regarding voiding parameters after catheter removal did not reach statistical significance. One year after surgery, no significant difference between the two groups was found regarding urinary function and IPSS. Though not statistically significant either, the need for the incision of bladder neck contracture (BNC) in two patients in the UC group is of note, as in the SPT group, no BNC occurred.

Conclusion

Draining the bladder with SPT only is a feasible option in patients undergoing RALP. Patients with SPT are significantly less bothered by the catheter at personal and genital hygiene compared to UC. The risk of BNC seems to be reduced in the SPT group.

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Abbreviations

SPT:

Suprapubic tube

UC:

Urethral catheter

RALP:

Robot-assisted laparoscopic prostatectomy

DOS:

Day of surgery

POD:

Post-operative day

BNC:

Bladder neck contracture

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Acknowledgments

We would like to thank Prof. Dr. Christel Weiss for her help with statistical analysis. The work is part of B. Rafail’s dissertation work.

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    Authors and Affiliations

    1. Department of Urology, University Medical Centre Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany

      A. Martinschek, D. Pfalzgraf, B. Rafail, M. Ritter, E. Heinrich & L. Trojan

    2. Department of Urology, German Military Hospital Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany

      A. Martinschek

    3. Department of Urology, University Medical Centre Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany

      E. Heinrich & L. Trojan

    Authors
    1. A. Martinschek
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    2. D. Pfalzgraf
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    3. B. Rafail
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    4. M. Ritter
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    5. E. Heinrich
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    Correspondence to D. Pfalzgraf.

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    Additional information

    A. Martinschek and D. Pfalzgraf have contributed equally to this work.

    A. Martinschek and D. Pfalzgraf shared first authorship.

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    Martinschek, A., Pfalzgraf, D., Rafail, B. et al. Transurethral versus suprapubic catheter at robot-assisted radical prostatectomy: a prospective randomized trial with 1-year follow-up. World J Urol 34, 407–411 (2016). https://doi.org/10.1007/s00345-015-1678-1

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    • DOI: https://doi.org/10.1007/s00345-015-1678-1

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