Urethral catheter removal 7 or 14 days after radical retropubic prostatectomy: clinical implications and complications in a randomized study.
OBJECTIVE
To evaluate the hypothesis that a 7-day period of indwelling catheter after radical retropubic prostatectomy is effective and safe without the need of performing cystography.


METHODS
In the period from January of 2000 to July of 2002, 73 patients underwent radical retropubic prostatectomy, and these patients were prospectively randomized in 2 groups: Group 1-37 patients who had the urethral catheter removed 7 days after the procedure, and Group 2-36 patients who had the catheter removed 14 days after the surgery. The 2 groups were similar, the surgeons and the technique were the same, and no cystography was performed to evaluate the presence of leaks.


RESULTS
Two patients in Group 1 had bleeding and clot retention after having the catheter taken out in the seventh postoperative day and were managed by putting the catheter back in for 7 more days. Two patients in Group 2 developed bladder neck stricture and were treated by bladder neck incision with success. The continence rate was the same, with 2 cases of incontinence in each group. About 2 pads a day were used by the patients with incontinence. The average follow-up was 17.5 months (12-36 months). No urinary fistula, urinoma, or pelvic abscesses developed after catheter removal. Two patients were excluded from the analysis of this series: 1 died with a pulmonary embolus in the third postoperative day, and 1 developed a urinary suprapubic fistula before catheter withdrawal, which was maintained for 16 days.


CONCLUSIONS
Withdrawal of the urethral catheter 7 days after radical retropubic prostatectomy, without performing cystography, has a low rate of short-term complications that are equivalent to withdrawal 14 days after the surgery.
Souto
Carlos Ary Vargas
CA
Division of Urology of the Santa Casa of Porto Alegre (ISCMPA) and Federal Foundation of Porto Alegre (FFFCMA) - Porto Alegre/Rio Grande do Sul, Brazil. cavsouto@hotmail.com
Rhoden
Ernani Luis
EL
De Conti
Rafael
R
Chammas
Mário
M
Laste
Sandro Eduardo
SE
Fornari
Alexandre
A
Ribeiro
Eduardo Porto
EP
Scholl
Liana
L
Teloken
Claudio
C
Souto
José Carlos Stumpf
JC
D000368:Aged; D002408:Catheters, Indwelling / Q000009:adverse effects; D016009:Chi-Square Distribution; D020878:Device Removal / Q000592:standards*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000601:surgery*; D013997:Time Factors; D014546:Urinary Catheterization / Q000295:instrumentation*