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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Urology 1/2015

Comparison of continence outcomes of early catheter removal on postoperative day 2 and 4 after laparoscopic radical prostatectomy: a randomized controlled trial

Zeitschrift:
BMC Urology > Ausgabe 1/2015
Autoren:
Masashi Matsushima, Akira Miyajima, Seiya Hattori, Toshikazu Takeda, Ryuichi Mizuno, Eiji Kikuchi, Mototsugu Oya
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

SH, TT, and MM formulated the database. MM performed the initial analyses and drafted the first manuscript. All authors assisted in the analysis and interpretation of data. RM, EK, and MO critically discussed the data and manuscript. AM conceived the study, participated in its design and coordination, and helped to draft the manuscript. All authors read and approved the final manuscript.

Abstract

Background

The optimal timing of catheter removal following laparoscopic radical prostatectomy (LRP) has not yet been determined. This prospective study was designed to compare the efficacy and safety of catheter removal on postoperative day (POD) 2 versus POD 4 after LRP and its impact on urinary continence outcomes.

Methods

One hundred and thirteen patients underwent LRP and were prospectively randomized into two groups: group 1 (n = 57) had the urinary catheter removed on POD 2 while group 2 (n = 56) had the catheter removed on POD 4. The urine loss ratio (ULR) was defined as the weight of urine loss in the pad divided by the daily micturition volume. Continence was defined as a pad-free status.

Results

No significant differences were observed in clinical features between groups 1 and 2. Acute urinary retention (AUR) after catheter removal occurred in 21 patients (18.6 %) (13 (22.8 %) in group 1 and 8 (14.3 %) in group 2 (p = 0.244). The first-day mean ULR values were 1.16 ± 4.95 in group 1 and 1.02 ± 3.27 in group 2 (p = 0.870). The last-day mean ULR values were 0.57 ± 1.60 in group 1 and 2.78 ± 15.49 in group 2 (p = 0.353). Continence rates at 3, 6, 9, and 12 months were 21.8, 41.1, 58.0, and 71.4 % in group 1 and 34.5, 66.0, 79.2, and 83.7 % in group 2 (p = 0.138, 0.009, 0.024, and 0.146, respectively). In AUR cases, continence rates at 3, 6, 9, and 12 months were 0, 23.1, 38.5, and 54.5 % in group 1 and 37.5, 75.0, 87.5, and 87.5 % in group 2 (p = 0.017, 0.020, 0.027, and 0.127, respectively). A multivariate analysis identified AUR after catheter removal on POD 2 as the only predictive factor for incontinence 6 and 9 months after LRP (p = 0.030 and 0.018, respectively).

Conclusions

Our results demonstrated that early catheter removal on POD 2 after LRP may increase the risk of incontinence.

Trial registration

The study was registered as Clinical trial: (UMIN000014944); registration date: 12 March 2012.
Literatur
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