title: An Assessment of Patient Comfort and Morbidity After Robot-Assisted Radical Prostatectomy with Suprapubic Tube Versus Urethral Catheter Drainage.
abstract: OBJECTIVE
  Robot-assisted laparoscopic prostatectomy (RALP) with suprapubic tube (SPT), compared to urethral catheter (UC) drainage, has been proposed to improve patient comfort and recovery. We sought to compare short-term outcomes for pain and morbidity after RALP with SPT vs UC drainage.
  
  
  METHODS
  Between August 2012 and 2014, 159 men underwent a RALP and prospectively completed a questionnaire addressing postoperative pain and satisfaction. Group 1 (n = 94) underwent a RALP by one surgeon who placed a UC and removed it between postoperative day (POD) 7 and 10. Group 2 (n = 65) underwent a RALP by a different surgeon who placed an SPT and UC. On POD 1, the UC was removed. On POD 9, the SPT was capped and removed on POD 11 if the patient was voiding adequately. Preoperative and intraoperative data, complications, questionnaires, and patient-reported morbidity, including unplanned telephone calls and emergency department (ED) visits, were compared between groups.
  
  
  RESULTS
  Patient characteristics were similar between groups. One week after surgery, the penile pain score was statistically significantly lower in Group 2 compared to Group 1 (56.9% and 79.8%, respectively, reported minimal-to-moderate pain, p = 0.003). Bladder spasms and overall pain were not significantly higher for Group 1 compared to Group 2 (p > 0.05). When asked "How big a problem has your urine storage device been?," 20.2% of patients in Group 1 reported it as a "moderate-to-big" problem compared to 10.8% in Group 2 (p > 0.05). The number of catheter-related unplanned telephone encounters did not differ between the two groups (p = 0.7), however, although not statistically significant, 4.6% of patients in Group 2 presented to the ED with catheter-related issues (p = 0.07).
  
  
  CONCLUSIONS
  SPT after RALP was associated with less penile pain compared to UC drainage, and modestly better patient satisfaction. There were no significant differences in bladder spasms, overall pain, and patient-reported morbidity between groups.
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center , Dallas, Texas.
authors.forename: Monica S C
authors.initials: MS
authors.lastname: Morgan
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center , Dallas, Texas.
authors.forename: Asim
authors.initials: A
authors.lastname: Ozayar
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center , Dallas, Texas.
authors.forename: Justin I
authors.initials: JI
authors.lastname: Friedlander
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center , Dallas, Texas.
authors.forename: Nabeel
authors.initials: N
authors.lastname: Shakir
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center , Dallas, Texas.
authors.forename: Jodi A
authors.initials: JA
authors.lastname: Antonelli
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center , Dallas, Texas.
authors.forename: Selahattin
authors.initials: S
authors.lastname: Bedir
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center , Dallas, Texas.
authors.forename: Claus G
authors.initials: CG
authors.lastname: Roehrborn
authors.affiliation: Department of Urology, University of Texas Southwestern Medical Center , Dallas, Texas.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Cadeddu
mesh_terms: D000368:Aged; D003559:Cystostomy / Q000379:methods*; D004322:Drainage; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D010149:Postoperative Pain / Q000453:epidemiology* / Q000503:physiopathology; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology*; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods; D011795:Surveys and Questionnaires; D014546:Urinary Catheterization / Q000379:methods*; D062885:Urinary Catheters