Early catheter removal 3 days after radical retropubic prostatectomy.
OBJECTIVE
We investigated the feasibility and safety of the early removal of urethral catheters 3 days after radical retropubic prostatectomy.


METHODS
Seventy consecutive patients underwent radical retropubic prostatectomy with the intent of early catheter removal on postoperative day (POD) 3. Catheter removal was based on postoperative cystograms performed on POD 2. Patients were analyzed using a validated prostate cancer specific questionnaire (University of California, Los Angeles Prostate Cancer Symptom Index) to determine quality of life outcomes. Multiple logistic regression analysis was also used to evaluate if any of the preoperative or intraoperative parameters were able to predict the success of early catheter removal after radical retropubic prostatectomy.


RESULTS
The catheter was removed on POD 3 in 67 of 70 patients (97%) excluding three patients with moderate or severe extravasation on postoperative cystograms. Of the 67 patients, 53 (76%) were successful in early catheter removal, but the remaining 14 (24%) patients experienced urinary retention within 48 h and were treated with simple catheter replacement for 1 or 2 days. Two patients developed anastomotic strictures 3 and 4 months postoperatively, which were managed by dilation alone. Multiple logistic regression analysis showed that no leak during an intraoperative leak test was the only independent predictor of success for early catheter removal (P = 0.0069; odds ratio, 6.667; 95% confidence interval, 1.682-26.428).


CONCLUSIONS
The present study revealed that early catheter removal 3 days after radical retropubic prostatectomy is feasible in patients who show a negative intraoperative leak test. Postoperative monitoring of more patients is needed to determine if the early catheter removal is widely applicable.
Noguchi
Masanori
M
Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka, Japan. noguchi@med.kurume-u.ac.jp
Shimada
Akihiko
A
Yahara
Jyunro
J
Suekane
Shigetaka
S
Noda
Shinshi
S
D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D003287:Contrast Media; D005119:Extravasation of Diagnostic and Therapeutic Materials; D005240:Feasibility Studies; D006801:Humans; D007430:Intraoperative Care; D016015:Logistic Models; D008297:Male; D017063:Outcome Assessment, Health Care; D011182:Postoperative Care; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D014525:Urethral Stricture / Q000209:etiology; D014546:Urinary Catheterization; D016055:Urinary Retention / Q000175:diagnosis / Q000209:etiology
D003287:Contrast Media