Attention: Restrictions on use of AUA, AUAER, and UCF content in third party applications, including artificial intelligence technologies, such as large language models and generative AI.
You are prohibited from using or uploading content you accessed through this website into external applications, bots, software, or websites, including those using artificial intelligence technologies and infrastructure, including deep learning, machine learning and large language models and generative AI.
UPJ INSIGHT Suprapubic vs Urethral Catheterization Following Pelvic Fascia‒Sparing Robotic Prostatectomy
By: Samuel Engelsgjerd, MD, MedStar Georgetown University Hospital, Washington, District of Columbia; Sarah Kodres-O’Brien, MD, Georgetown University School of Medicine, Washington, District of Columbia; Eshrar Choudhury, MD, Georgetown University School of Medicine, Washington, District of Columbia; Belén Mora Garijo, MD, MedStar Georgetown University Hospital, Washington, District of Columbia; J. Bradley Mason, MD, MedStar Georgetown University Hospital, Washington, District of Columbia; Keith J. Kowalczyk, MD, MedStar Georgetown University Hospital, Washington, District of Columbia, Georgetown University School of Medicine, Washington, District of Columbia | Posted on: 18 Mar 2024
Engelsgjerd S, Kodres-O’Brien S, Choudhury E, Garijo BM, Mason JB, Kowalczyk KJ. Outcomes and safety of suprapubic vs urethral catheterization following pelvic fascia—sparing robotic prostatectomy. Urol Pract. 2024;11(2):376-384
Study Need and Importance
Urethral catheter (UC) discomfort remains a burden following robotic-assisted radical prostatectomy (RARP), and suprapubic catheters (SPCs) may reduce patient discomfort and increase satisfaction. There are limited data on SPC in the setting of pelvic fascia–sparing (PFS) RARP, so we examined the postoperative outcomes of SPC vs UC placement following PFS-RARP.
What We Found
Between the 2 cohorts, there were no differences in complications, including urethral stricture or anastomotic leak. Patients receiving SPC vs UC had earlier return to continence (7 vs 16 days, P < .001) and higher continence rates at catheter removal (67.6% vs 43.3%, P = .0003). On adjusted analyses, SPC was an independent predictor of continence at catheter removal (OR 2.21, P = .023). There were no differences between groups in preoperative or postoperative EPIC-CP (Expanded Prostate Cancer Index Composite for Clinical Practice) scores, including no differences in postoperative quality of life (P = .46).
Limitations
First, our questionnaire is limited in the specific questions we are able to answer, and it is possible the significance of the data is affected by the timing of questionnaire administration. In the future, it would be helpful to add questions related to penile or suprapubic pain while having the catheter in place. The 6-week administration of the EPIC-CP is well after catheter removal, and thus vitality scores from that time are unlikely to reflect vitality directly associated with the catheter. Second, this is a retrospective review of a prospective database and not a randomized controlled trial. Finally, as a single-surgeon series, where UC was used for approximately the first 100 patients and SPC was used for the latter patients, it is possible that increasing surgeon experience introduces bias into the results.
Interpretation for Patient Care
Our study provides compelling evidence supporting the use of SPC as a safe and viable alternative to UC after PFS-RARP.
advertisement
advertisement