Modification of Technique for Suprapubic Catheter Placement After Robot-assisted Radical Prostatectomy Reduces Catheter-associated Complications

Abstract

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. 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. 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 6weeks 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). 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.