PURPOSE: Retrospective single institution data suggested that post-operative pain following robot-assisted laparoscopic radical prostatectomy (RALP) was reduced with early removal of the urethral catheter (UC) with suprapubic tube (SPT) drainage. The objective of this study was to determine whether SPT drainage with early UC removal improves post-operative pain compared with UC drainage alone in a randomized patient population.
MATERIALS AND METHODS: Men with BMI < 40 with newly diagnosed prostate cancer electing to undergo RALP were included. Stratified (by surgeon) block randomization was utilized and randomization assignment was performed following completion of the urethrovesical anastomosis. In patients assigned to SPT drainage, UCs were removed on post-operative day (POD) 1 and all catheters removed on POD7. Visual analog pain scale (VAS) and satisfaction questionnaires were administered on POD 0, 1 and 7.
RESULTS: Twenty-nine patients were randomized to UC vs. 29 to SPT plus early UC removal at the time of interim futility analysis. Mean VAS scores did not differ between groups at any time points and similar percentages of patients cited the catheter as their greatest bother with non-significant differences in treatment-related satisfaction. Complications within the first week of surgery did not vary between groups. Based on the interim results, the trial was terminated for lack of effect.
CONCLUSIONS: Patients randomized to SPT versus UC drainage for the week following prostatectomy had similar pain, catheter-related bother, and treatment-related satisfaction in the perioperative period. We no longer routinely offer SPT with early UC removal at our institution.
Written by:
Prasad SM, Large MC, Patel AR, Famakinwa O, Galocy RM, Karrison T, Shalhav AL, Zagaja GP. Are you the author?
Department of Urology, Medical University of South Carolina, Charleston, SC; Section of Urology, University of Chicago Hospitals, Chicago, IL; Department of Urology, DuPage Medical Group, Downers Grove, IL; Department of Health Studies, University of Chicago Hospitals, Chicago, IL; Department of Urology, DuPage Medical Group, Downers Grove, IL.
Reference: J Urol. 2014 Jan 14. pii: S0022-5347(14)00015-9.
doi: 10.1016/j.juro.2014.01.004
PubMed Abstract
PMID: 24440236
Go "Beyond the Abstract" - Read an article written by the authors for UroToday.com
UroToday.com Prostate Cancer Section
