PURPOSE: Acute urinary retention (AUR) following catheter removal is a recognized complication after open or robot-assisted radical prostatectomy (RARP).
We evaluated patient and surgery-related risk factors to determine if AUR can be prevented, which has not previously been done for prostatectomy by any technique.
METHODS: We reviewed a single-surgeon RARP database of patients treated between February 2008 and June 2011 for AUR following catheter removal, which was routinely performed 3 to 7 days postoperatively. Characteristics of patients with and without AUR were compared.
RESULTS: Of 1026 patients, 25 (2.4%) experienced AUR. There was no difference between patients with and without AUR in mean age, BMI, blood loss, or prostate size, nor any difference in the frequency of bladder neck reconstruction or nerve-sparing. Catheter removal occurred on average on postoperative day (POD) 4.1 vs. 5.7 in patients with and without AUR. Of 25 patients with AUR, 22 (88%) underwent catheter removal on POD 3 or 4. Although only 3 of 381 patients (0.8%) had a leak on cystogram on POD 3 or 4, the AUR rate when the catheter was removed on day 3 or 4 was 5.8% (22/381), which was several times higher than in those who wore the catheter for >4 days (3/645 or 0.5%).
CONCLUSIONS: AUR after robotic prostatectomy occurs infrequently. No patient-related risk factors were identified beyond catheterization time. Although the catheter may be removed after 3-4 days with rare leaks, AUR risk was much less when the catheter was left in place at least 5 days.
Written by:
Khemees TA, Novak R, Abaza R. Are you the author?
Department of Urology, The Ohio State University Wexner Medical Center & James Cancer Hospital, Columbus, OH.
Reference: J Urol. 2012 Sep 25. pii: S0022-5347(12)04993-2.
doi: 10.1016/j.juro.2012.09.097
PubMed Abstract
PMID: 23021999
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