Methods
The authors conducted a prospective randomized trial with 3 arms with a 1:1:1 randomization ratio of patients undergoing RALRP. The 3 arms included:
- Transurethral catheter removed on day 5 (group 1)
- Suprapubic catheter removed on day 5 (group 2)
- Suprapubic catheter removed on day 2 (group 3)
Results
A total of 198 patients were enrolled between June 2016 and July 2017. Only 11 patients had dropped out of the study. No difference between the groups were noted in regards to age, BMI, TRUS prostate volume, preoperative PSA, IPSS and Gleason score.
No differences were noted in the residual bladder volume. Furthermore, no differences could be discerned with regards to complications, however, a significant difference was noted in their insentience, with group 1, group 2, and group 3 patients having 30, 24, and 14 cc on their 12 hour pad test. Four weeks after surgery, continence (less than 1 pad/day) was achieved in 51%, 62% and 76% of patients in groups 1,2, and 3, respectively.
Conclusions
The authors concluded that there are comparable outcomes for postoperative patient comfort, complication rates and voiding quality in the groups. However, significant differences exist in short term continence rates 4 weeks after catheter removal. RALRP with early removal of a suprapubic catheter may lead to improved early continence.
Presented By: Nina Harke, Gronau, Germany
Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre @GoldbergHanan at the 2018 North American Robotic Urology Symposium, February 16-17, 2018 - Las Vegas, NV