title: Modification of Technique for Suprapubic Catheter Placement After Robot-assisted Radical Prostatectomy Reduces Catheter-associated Complications.
abstract: OBJECTIVE
  To compare the outcomes of patients undergoing robot-assisted radical prostatectomy (RARP) with urinary drainage using a modified technique for suprapubic catheter (SPC) placement with those undergoing a previously described technique for SPC placement and those with urethral catheter (UC) alone.
  
  
  METHODS
  We reviewed the records of 225 consecutive patients who underwent RARP by a single surgeon. The most recent patients were contacted via a telephone survey with 86 responses (69%) received.
  
  
  RESULTS
  After RARP, 174 patients had only UC placement (77%) and 51 had an SPC placed (23%). Twelve patients had SPC placement with a 4-mL balloon (SPC-4), with catheter-related complications occurring in four patients (33%). The technique was modified to use SPC with a 10-mL balloon (SPC-10). Only 2 of 39 SPC-10 patients (5%) had catheter-related complications (P = .03 vs SPC-4). Continence rates at 6 weeks were 83% and 82% for UC and SPC, respectively. Based on postoperative survey results using a 10-point scale, overall experience with RARP was rated 8.9 ± 1.7 and 8.7 ± 2.3 for UC and SPC, respectively (P = .63). Mean catheter bother was rated 5.1 ± 3.0 and 4.6 ± 2.9 for UC and SPC, respectively (P = .45).
  
  
  CONCLUSIONS
  SPC provides a safe option for patients who would prefer not to have UC following RARP, with equivalent perioperative outcomes. Modification of the published technique to place a standard 16F catheter results in fewer catheter-related complications.
authors.affiliation: Division of Urology, Spectrum Health Hospital System, Grand Rapids, MI; Grand Rapids Medical Education Partners, Grand Rapids, MI.
authors.forename: Muhammad Zubair
authors.initials: MZ
authors.lastname: Afzal
authors.affiliation: Grand Rapids Medical Education Partners, Grand Rapids, MI; Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, MI.
authors.forename: Conrad M
authors.initials: CM
authors.lastname: Tobert
authors.affiliation: Grand Rapids Medical Education Partners, Grand Rapids, MI; Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, MI.
authors.forename: Emi
authors.initials: E
authors.lastname: Bulica
authors.affiliation: Division of Urology, Spectrum Health Hospital System, Grand Rapids, MI.
authors.forename: Sabrina L
authors.initials: SL
authors.lastname: Noyes
authors.affiliation: Division of Urology, Spectrum Health Hospital System, Grand Rapids, MI; Department of Surgery, Michigan State University College of Human Medicine, Grand Rapids, MI. Electronic address: brian.lane@spectrumhealth.org.
authors.forename: Brian R
authors.initials: BR
authors.lastname: Lane
mesh_terms: D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D011468:Prostatectomy / Q000379:methods*; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D014546:Urinary Catheterization / Q000009:adverse effects* / Q000379:methods*; D062885:Urinary Catheters