Indwelling Urethral Catheter Research Articles

A steady stream of knowledge: decreased urinary retention after implementation of ERAS protocols in ambulatory minimally invasive inguinal hernia repair.

Potential complications after inguinal hernia repair include uncontrolled post-operative pain and post-operative urinary retention (POUR). Enhanced Recovery After Surgery (ERAS) protocols aim to mitigate post-operative morbidity. We study the impact of ERAS measures alongside discharge without a narcotic prescription on post-operative pain and POUR after minimally invasive inguinal hernia repair. A retrospective review of a prospectively maintained database identified patients that underwent minimally invasive inguinal hernia repair at a single institution. Intra-operative data included operative time, narcotic usage, non-narcotic adjunct medication, and fluid administration. Primary outcomes included rates of POUR and uncontrolled post-operative pain. Operations performed after 2018 were included in the ERAS cohort. Uncontrolled post-operative pain was defined as needing additional narcotic prescriptions, admission, or ER visits for post-operative pain. POUR was defined as requiring an indwelling urethral catheter at discharge, admission for retention, or returning to the ER for urinary retention. Between January 2008 and March 2021, 1097 patients who underwent minimally invasive inguinal hernia repair were identified. 91.3% of these procedures were laparoscopic and 8.7% were robotic. Average patient age was 57.4years, 93% were male. Patients receiving care after initiation of the ERAS protocol were significantly less likely to experience POUR when compared to their prior counterparts (1.4% vs. 4.2% p = 0.01); there was no difference in post-operative pain complications (1.4% vs. 2.9% p = 0.15). Patients who were discharged without a narcotic prescription had 0% incidence of POUR. Significant differences were found between the ERAS and non-ERAS cohort regarding narcotic usage and fluid administration. Age, higher fluid volume, and higher narcotic usage were found to be risk factors for POUR while ERAS, sugammadex, and dexamethasone were found to be protective. Implementation of an ambulatory ERAS protocol can significantly decrease urinary retention and narcotic usage rates after minimally invasive inguinal hernia repair.

For adults with short-term indwelling urethral catheters, what are the effects of prophylactic alpha blockers?

For adults with short-term indwelling urethral catheters, what are the effects of prophylactic alpha blockers?

For adults with short-term indwelling urethral catheters, how does clamping compare with free drainage?

For adults with short-term indwelling urethral catheters, how does clamping compare with free drainage?

For adults with short-term indwelling urethral catheters, how does early removal compare with later removal?

For adults with short-term indwelling urethral catheters, how does early removal compare with later removal?

For adults with short-term indwelling urethral catheters, does time of day the catheter is removed affect outcomes?

For adults with short-term indwelling urethral catheters, does time of day the catheter is removed affect outcomes?

Clinical significance of Catheter-Associated Urinary Tract Infection (CAUTI) in Intensive Care Units: Three Year Experience at a Single Centre

Introduction: Catheter Acquired Urinary Tract Infection (CAUTI) is one of the most common Health Care Acquired Infections (HCAI); most of these infections are attributable to use of an indwelling urethral catheter. The aim of this study was to investigate patients with catheter-associated urinary tract infection over three years at a single hospital’s Intensive Care Unit (ICU) and to identify meaningful risk factors and causative organisms. 
 Methods: A retrograde analysis was performed on patients with indwelling catheters in ICU of Armed Forces Medical College, Pune, India. CAUTI was defined as isolated bacterial growth of 100,000 colony-forming units or more either 48 hours after transfer to the ICU if a urinary catheter was placed before the transfer or 48 hours after insertion if the catheter was inserted in the ICU. Only the patients whose culture results were negative before ICU admission were included.
 Result: Among 350 samples collected in medical and surgical ICU, 38 patients (10.85%) had CAUTI. Using multivariate logistic regression analysis, the study showed that those with diabetes were 4.51 (p＜0.001) times likely to have occurrences of CAUTI than those without and also showed an increased incidence of CAUTI > 1.19 fold (p＜0.01) among patient with longer duration of an indwelling catheter.
 Conclusions: CAUTI is a preventable HCAI and thus the risk factors and causative organisms contributing to its development in the management of ICU patients must be considered to prevent the occurrence of UTIs in this setting.

V10-08 DISTAL URETHRECTOMY AND ADVANCEMENT URETHROPLASTY FOR URETHRAL MEATUS STRICTURE IN FEMALE PATIENTS

You have accessJournal of UrologyLower Tract Reconstruction (V10)1 Sep 2021V10-08 DISTAL URETHRECTOMY AND ADVANCEMENT URETHROPLASTY FOR URETHRAL MEATUS STRICTURE IN FEMALE PATIENTS Camille Haudebert, Juliette Hascoet, Lucas Freton, Andrea Manunta, Nirit Rosenblum, Benjamin Brucker, and Benoit Peyronnet Camille HaudebertCamille Haudebert More articles by this author , Juliette HascoetJuliette Hascoet More articles by this author , Lucas FretonLucas Freton More articles by this author , Andrea ManuntaAndrea Manunta More articles by this author , Nirit RosenblumNirit Rosenblum More articles by this author , Benjamin BruckerBenjamin Brucker More articles by this author , and Benoit PeyronnetBenoit Peyronnet More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002061.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Female urethral stricture is a rare condition. Distal stricture have usually been managed using meatoplasty. Advancement urethroplasty might be an interesting surgical alternative to meatoplasty. METHODS: We present the case of a 79 year-old female. She reported voiding symptoms for several years: slow stream, hesitancy and straining to void. On physical examination a narrowing of the urethral meatus is noted. The cystoscopy was not possible during the visit because of the stricture, the stricture could only be catheterized with a 12 Fr urethral dilator. We offered to do a distal urethrectomy and advancement urethroplasty. RESULTS: The stricture is easily identified on physical examination. Two holding stiches are place within the urethral lumen. An incision is made just above the dorsal aspect of the urethral meatus. The dorsal urethra is then opened longitudinally until healthy tissue is found above the stricture. Here the stricture is about one centimeter long. To confirm that the incision has reached healthy urethral tissue, an urethro-cystoscopy is performed. Before further pursuing the incision, the healthy urethra is sutured to the vaginal aspect of the incision at 12 o’clock to start the advancement urethroplasty using 5/0 pds. The incision is then carried out to the ventral circumference of the urethral meatus. The distal urethrectomy is completed, making sure to remove all the thickened fibrotic tissue. Additional stitches are placed all around the new urethral meatus to complete the advancement urethroplasty. An indwelling 16F urethral catheter is placed at the end of the procedure. The operative time was 30 minutes with minimal blood loss. There was no postoperative complications. The patient was discharged on postoperative day 2 and the urethral catheter on day 8. The patient resumed spontaneous voiding and was completely relieved of her voiding symptoms. She did not experience stress urinary incontinence postoperatively. CONCLUSIONS: Distal urethrectomy with advancement urethroplasty is safe and feasible in female patients with relatively short (up to 1 cm long) stricture of the distal urethra. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e757-e757 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Camille Haudebert More articles by this author Juliette Hascoet More articles by this author Lucas Freton More articles by this author Andrea Manunta More articles by this author Nirit Rosenblum More articles by this author Benjamin Brucker More articles by this author Benoit Peyronnet More articles by this author Expand All Advertisement Loading ...

Strategies for the removal of short-term indwelling urethral catheters in adults.

Strategies for the removal of short-term indwelling urethral catheters in adults.

The impact of guidelines on sterility precautions during indwelling urethral catheterization at two acute-care hospitals in Sweden - a descriptive survey

BackgroundTo support a uniform and evidence-based practice for indwelling urinary catheterization in adults The European association of Urology Nurses (EAUN) published guidelines for this procedure in 2012. The Swedish national guidelines are based on the sterility precautions advocated by EAUN. Some hospitals have local guidelines with other requirements concerning sterility and leave to staff to decide how to perform the catheterization. The aim of this descriptive survey was to investigate the nurses´ self-reported sterility precautions during indwelling urethral catheterization at two acute-care hospitals, where the local guidelines differ in their sterility requirements. The study also aimed to analyze factors affecting conformity with sterility precautions in the EAUN-guidelines.MethodsA structured questionnaire with questions concerning the participant, working conditions and performance of indwelling urethral catheterization was left to 931 nurses in two acute care hospitals. Chi-square test, Fisher’s exact test and Mann-Whitney U-test were used for descriptive statistics. Logistic regression was used to analyze variables associated with practicing the sterility precautions in the EAUN-guidelines.ResultsAnswers were obtained from 852 persons (91.5%). Most of the participants called their insertion technique “non-sterile”. Regardless of designation of the technique the participants said that the indwelling urinary catheter (IUC) should be kept sterile during procedure. Despite that not everyone used sterile equipment to maintain sterility of the catheter. The nurses´ conformity with all the sterility precautions in the EAUN-guidelines were associated with working at departments for surgery and cardiology (OR 2.35, 95% CI 1.69–3.27), use of sterile set for catheterization (OR 2.06, 95% CI 1.42–2.97), use of sterile drapes for dressing on insertion area (OR 1.91, 95% CI 1.24–2.96) and using the term “sterile technique” for indwelling urethral catheterization (OR 1.64, 95% CI 1.11–2.43).ConclusionsOnly 55–74% of the nurses practiced one or more precautions that secured sterility of the IUC thus demonstrating a gap between the EAUN-guidelines and the actual performance. Adherence to the guidelines was associated with factors that facilitated an aseptic performance such as using a sterile set and sterile drapes.Healthcare-settings should ensure education and skill training including measures to ensure that the IUC is kept sterile during insertion.

805. A Single Institution Pre/Post Comparison After Introduction of an External Urinary Collection Device for Female Medical Patients

BackgroundCatheter associated urinary tract infections (CAUTIs) are the most common hospital acquired infections in the United States. External urinary collection devices (EUCDs) may serve as an alternative to indwelling urethral catheters (IUCs) and decrease the rate of CAUTIs. PureWick® is a novel female EUCD, with early case reports suggesting safe and efficacious use. However, no study has definitively proven benefit of PureWick® regarding reduction of CAUTIs. We sought to compare the CAUTI rate and median indwelling catheter days before and after availability of PureWick® at a single academic institution, as well as provide a descriptive analysis on female medical patients receiving an EUCD.MethodsWe performed a retrospective review of adult female patients admitted to our institution on a medical service who received an IUC and/or an EUCD. Patients admitted in the 3 months before (PRE) and 12 months after (POST) PureWick® availability were included. Two groups were compared: PRE patients who received an IUC vs. POST patients who received an IUC and/or EUCD.ResultsOut of 866 female patients, 296 received an EUCD in the POST cohort and overall, 673 received an IUC (261 (100%) PRE vs. 412 (68.1%) POST). There were no differences in the cohorts regarding age and comorbidities (all p >0.05). Compared to the PRE cohort, the POST cohort had a higher number of IUC days (median, 3 vs. 2 days, p< 0.001) and a higher rate of CAUTI (infections per 1,000 catheter days, 11.8 vs. 4.1, p=0.003) while overall UTI rate was similar (infections per 1,000 patient days, 19.1 vs. 14.12, p=0.410). In the POST cohort, the rate of UTI associated with EUCD use was 11.6 infections per 1,000 device days. Measurement of strict ins and outs (56.8%) was the most common indication for use of EUCD.Table 1. Characteristics and comorbidities of female catheterized patients admitted to a medical service before (PRE) and after (POST) PureWick implementation. Table 2. Urinary tract infection rates of female catheterized patients PRE and POST PureWick implementation. Table 3. Characteristics of hospitalized female patients admitted to a medical service who received a PureWick catheter. ConclusionWhile EUCDs might appear to be a promising alternative to IUCs for female patients, this single center pre/post analysis found that both the median number of IUC days and the CAUTI rate increased after introduction of a single EUCD. This may be related to selection bias, with EUCDs being ordered for patients who would not have otherwise received an IUC. Further research is needed to clarify if female EUCDs can be effective in decreasing IUC days and/or CAUTI rates prior to any widespread adoption.Disclosures All Authors: No reported disclosures

Chronic indwelling foley catheter, a risk factor for catheter associated urinary tract infection.

Catheter associated infection is one of commonest infection which affects hospital admitted patients. Indwelling urethral catheters which are kept in place for 30 days or less are called short term. Whereas, when catheter placement exceeds 30 days, it is known as chronic or long term. Objectives: This study was intended to investigate the frequency of urinary tract infection caused by chronic indwelling urethral catheters. Study Design: Cross Sectional study. Setting: Department of Urology &amp; Renal Transplantation, Allied Hospital, Faisalabad. Period: 6 months between 01-12-2015 to 31-05-2016. Material &amp; Methods: Informed consent was taken from all the 100 patients which were selected for the research purpose. Under aseptic conditions, indwelling urethral catheter was replaced. The Foley catheter tip which we had taken out was cut and separated. It was delivered to the pathologist for culture and sensitivity in a secured axenic container. Diabetes was ruled out using blood sugar fasting levels. Data was recorded using a proforma. Results: In our study, out of 100 cases with chronic supra-pubic or urethral Foley catheter, 53% cases (n=53) were aged below 50 years while 47% (n=47) were aged above 50 years. Furthermore, 95% patients (n=95) were men and only 5% (n=5) were women. 18% participants of our study were recorded to have urinary infection associated with chronic catheterization. Conclusion: We found that urinary infection affects the patients having chronic indwelling urethral catheters significantly. Therefore, it is justified to assess every patient having urethral catheter for possible urinary infection.

From indwelling Foley to fail-safe voiding: Proposed changes in design and thinking

The Foley indwelling urethral catheter (IDC) has been an effective part of the clinician’s armoury for more than 80 years. It meets wide clinical needs, such as overcoming urinary retention for men and perioperative management, but its use risks the major iatrogenic conditions of catheter-associated urinary tract infection and urethral injury (CAUI) – the latter mainly in men. This article focuses on CAUI, examines some factors contributing to these risks, makes suggestions for design solutions which may help tackle them and invites collaboration to develop more effective and fail-safe IDC or voiding solutions.

Incidence and predictive factors for developing vesicoureteric reflux in individuals with suprasarcral spinal cord injury: a historical cohort study.

A historical cohort study OBJECTIVES: The aim of the study was to examine the incidence of and predictive factors for VUR in individuals with suprasacral spinal cord injury (SCI). Srinagarind Hospital, Khon Kaen University, Thailand METHODS: Medical records were reviewed for all individuals with SCI and neurogenic bladder admitted for urological check-up between 1996 and 2016. The primary outcome was the cumulative incidence of VUR. The statistical tests used included the Nelson-Aalen Estimator and Cox Proportional Hazard Ratio. Harrell's C concordance statistic was used to evaluate the discrimination ability of the predictive model. 293 participants with SCI (102 tetraplegic and 191 paraplegic) were included. Most participants were male (67%), and the median age was 52 years. The overall incidence of VUR was 7.5 cases per 100 person-years (95% CI, 6.15-9.4). In the multivariate analysis, the predictive factors for VUR were: (1) maximum detrusor pressure at first visit ≥ 75 cm of water (HRadj: 2.4 [95% CI: 1.4-4.1]); (2) indwelling urethral catheterization (IUC) (HRadj: 11.1 [95% CI: 3.9-31.7]) and clean intermittent catheterization (CIC) (HRadj: 6.5 [95% CI: 2.2-18.7]); (3) age ≥ 60 years at onset of SCI (HRadj: 1.7 [95% CI: 1.1-2.8]); and, (4) absence of antimuscarinic medication (HRadj: 3.8 [95% CI: 2.4-6.1]). The predictive model had an overall C-index of 0.78. The incidence of VUR was high up to 12 years after SCI. High maximum detrusor pressure, IUC, age ≥ 60 years and absence of antimuscarinic medication were predictive factors for VUR.

Managing complications associated with the use of indwelling urinary catheters.

The insertion of an indwelling urethral urinary catheter is an invasive procedure that is commonly undertaken in healthcare settings. However, there are several risks and potential complications associated with these devices, so their use should be avoided where possible. It is important that nurses are equipped with the necessary knowledge and skills not only to assess if a patient requires a catheter, but also to minimise the risk of associated complications and to understand how these can be managed. This article discusses some of the common complications that can occur with the use of indwelling urinary catheters, including: catheter-associated urinary tract infections; catheter blockages; encrustation; negative pressure; bladder spasm and trauma; and, in men, paraphimosis. It also explains the steps that nurses can take to reduce the risk of these complications and how to manage them effectively.

Prostat Spesifik Antijenin Akut Üriner Retansiyon Sonrası Üretral Kateter Yerleştirilen ve Benign Prostat Hiperplazisi Olan Hastalarda Prostat Adenokarsinomu Saptamadaki Rolü

Objective : Acute urinary retension (AUR) is one of the most important complications in benign prostate hyperplasia (BPH) patients and its treatment is generally urethral catheterization in acute period. There are studies showing that AUR and urethral catheter placement may cause an increase in serum PSA levels. Our objective in this study was to investigate the relation between increased PSA levels and prostate cancer (PCa) incidence in the patient group after AUR and urethral catheter placement. Materials and Methods : 77 patients who had an indwelling urethral catheter due to AUR, performed prostate biopsy due to high PSA levels and then surgical treatment for clinic BPH were retrospectively examined. Age, prostate volumes, pre-biopsy total serum PSA and PSA densities were noted. Total serum PSA rates, PSA densities and prostate volumes were compared for the groups that PCa was detected (n=6) and not detected (n=71) according to biopsy or surgical specimen results. Results : Mean age of the patients was 65.2±3.9 years. Mean prostate volume was measured as 64.1±12.8 g, mean serum total PSA level as 9.2±4.2 ng/mL and mean serum PSA density as 0.15±0.08 mg/mL/g. In PSA groups with a serum total PSA level of ≤4.0, 4-10, 10-20 and >20, PCa prevalence rates were detected 0%, 4.3%, 13.4% and 20%, respectively. Total PSA levels and PSA densities were found statistically higher in PCa detected group. Conclusion : PCa incidence is low in patients who were placed urethral catheter after AUR. For these patients prostate biopsy should be performed only in chosen cases.

Response to the Time

Response to the Time

NHSN Catheter-Associated Urinary Tract (CAUTI) Definition—Opportunity for Improvement

Background: Urinary tract infections (UTIs) are one of the most common hospital-acquired infections; ~70%–80% are attributable to an indwelling urethral catheter. Daily risk of bacteriuria acquisition varies from 3% to 7% with a catheter. CAUTIs are associated with increased mortality, cost, and inappropriate treatment of asymptomatic bacteriuria which promotes antimicrobial resistance and Clostridium difficile infection. NHSN CAUTI criteria is most commonly met when a patient has a positive urine culture and a fever. Although fever can be associated with many sources, it cannot be excluded from UTI determination even when attributable to another recognized source. Given the high prevalence of bacteriuria in catheterized patients and the many sources of fever, the NHSN definition lacks specificity. Objective: To better classify CAUTI using enhanced criteria to so that appropriate reduction efforts would be utilized. Methods: A retrospective review was conducted to evaluate NHSN-defined CAUTIs from July 2017 to December 2018. Patients with NHSN defined CAUTI were evaluated to determine elements present to meet criteria. Overcaptured (O-CAUTIs) were defined as follows: (1) O-CAUTI 1, a positive culture with fever attributable to an infectious source; (2) O-CAUTI 2, a positive culture with fever attributable noninfectious source; (3) O-CAUTI 3, repeated positive cultures outside the RI period; (4) O-CAUTI 4, a positive culture with symptoms attributable to another source and no fever. Classifications were discussed with the medical and clinical leadership to determine appropriate opportunities for improvement. Results: Overall, 49 NHSN CAUTIs were identified with 11 of 49 (22%) being true CAUTIs and 38 of 49 (78%) O-CAUTI. O-CAUTI 1 was most common, with 17 of 38 (45%). The most frequent attributable source of fever for O-CAUTI 1 (infectious source) was respiratory (7 of 17, 59%) followed by gastrointestinal (6 of 17, 35%). Also, 14 of 38 (37%) were O-CAUTI 2. Central fever was the most frequent source of fever for the noninfectious source (9 of 14, 64%) followed by drug fever (2 of 14, 14%). Of 38 patients, 3 (8%) had both an infectious and noninfectious reason for fever (CAUTI 1 and 2); 4 patients had no fever. Furthermore, 2 were O-CAUTI 3 (repeat culture positive) and 2 were O-CAUTI 4 (1 with hematuria and renal cell carcinoma and 1 with dysuria without leukocytosis). Conclusions: NHSN CAUTI definitions capture UTIs and other events. In FY2018, there were no true CAUTIs in 5 of 12 months (42%). Also, 50% of CDC CAUTIs were not UTI but could lead to inappropriate antibiotic use. Reviewing only CAUTI reduction work in O-CAUTIs prevents the assessment of other appropriate opportunities for improvement.Funding: NoneDisclosures: None

Antibiogram Audit of Catheter-associated Uropathogenic Isolates in University of Calabar Teaching Hospital, Calabar, Nigeria: Advocating Laboratory-based Prescription Practices

Background: The most important risk factor to developing UTI is the presence of an indwelling urethral catheter. Eighty percent of nosocomial UTI was reported to be caused by urethral catheterization. UTIs in health care institutions and in those with frequent antibiotic exposures were frequently caused by multi- drug resistant pathogens. This study sought to determined the antibiogram of isolates from catheterized patients with UTIs with a view to establishing if there were justifications for empiric treatment of this condition in the study area in the absence of quality antibiotic formulary.&#x0D; Materials and Methods: Interviewer administered questionnaires were used to collect socio-demographic data. Specimens were cultured on 5% sheep blood agar (SBA), MacConkey and sabouraud dextrose agar plates and incubated at 37°c for 24 hours in ambient air. Significant bacteriuria was determined on growths from SBA. Growths were identified using standard biochemical techniques.&#x0D; Results: The study established 74.3% (52) prevalence of CAUTIs amongst catheterized patients in the study area with 29 (41.4%) female dominance. Imipenem (93.9%) recorded the highest percentage susceptibility, followed by Amikacin (91.8%) and Piperacillin/ tazobactam (88.8%). E. coli 17(32.7%) was the dominant isolate. Extended spectrum β-lctamase prevalence was 23(44.2%) and MRSA 2(3.8%). There was significant statistical relation between ESBL production and resistance to other classes of antibiotics.&#x0D; Conclusion: There is high percentage prevalence of multidrug resistance (MDR) among isolates of CAUTIs in the study area. We therefore advocate laboratory based prescription practice and de-emphasized empiric treatment pending when there would be in a quality drug formulary founded on regular resistance surveillance.

Outcomes of Laparoscopic Radical Prostatectomies by a Single Surgeon Alternating Operating Position

The clinical outcome of laparoscopic radical prostatectomy (LRP) was retrospectively investigated taking into consideration the surgeon's position during the procedure. The study cohort included 184 consecutive patients who had undergone LRP performed by a single surgeon from February 2013 to July 2018. During the study period,the surgeon stood alternately on either the left or right side of the patient. The D'Amico risk classification was low,intermediate and high in 26 (14.1%),45 (24.5%) and 113 (61.4%) patients,respectively. Mean surgical duration was 203.5 minutes and mean estimated blood loss was 437.6 ml. Nerve sparing (NS) was implemented in 82 (44. 6%) patients. The mean period of having an indwelling urethral catheter was 5. 0 days. Perioperative Clavien-Dindo degree ≥IIIa complications occurred in three (1.6%) patients. Except for cases with presurgical hormonal treatment,surgical margins were positive in 41 (22.3%) patients,among whom 23 (17.4%) had pT2 disease. The 5-year biochemical recurrence-free survival rate was 81.4%,and 84.8% of patients regained urinary continence at 12 months after surgery. Where the surgeon stood during LRP was not associated with significant differences in any parameter. However,the margin positive rate was higher on the side away from where the surgeon stood than the side closer to the surgeon (70.7% vs 29.3%). In conclusion,the position of the surgeon during LRP does not influence the outcome.

Suprapubic Versus Urethral Catheter for Urinary Drainage After Robot-Assisted Radical Prostatectomy.

To review the evidence regarding the usage of suprapubic tube (SPT) versus indwelling urethral catheter (IUC) after robot-assisted radical prostatectomy (RARP). Available data on the use of SPT for urinary drainage after RARP is somewhat limited mostly because of the variations of study designs and non-standardized outcomes. Although it may provide some mild benefit in terms of catheter-related pain and discomfort, the benefit seems not to be clinically significant. The evidence in the literature so far does not support routine usage of SPT as the primary urinary drainage method after RARP. Further higher-quality studies that can show clinically significant advantages over IUC are still needed to justify its usage.