Obi AO. Combined urethral and suprapubic catheter drainage improves post operative management after open simple prostatectomy without bladder irrigation.
World J Clin Urol 2017;
6:44-50. [DOI:
10.5410/wjcu.v6.i2.44]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 02/23/2017] [Accepted: 04/17/2017] [Indexed: 02/06/2023] Open
Abstract
AIM
To compare outcomes after open simple prostatectomy without bladder irrigation, in subjects drained by combined 2-way urethral catheter and suprapubic catheter (SPC) vs those drained by 2-way urethral catheter only.
METHODS
A total of 84 participants undergoing Freyer’s simple prostatectomy over an 18-mo period were randomized into 2 groups (n = 42). Subjects in group 1 were managed with 2-way urethral catheter and in situ 2-way SPC while subjects in group 2 had a 2-way urethral catheter drainage only. In group 1 subjects, the SPC was spigotted and only used for drainage if there was clot retention. The primary outcomes were number of clot retention episodes, and number of clot retention episodes requiring bladder syringe evacuation. Other secondary outcomes evaluated were blood loss, requirement of extra analgesics, duration of surgery, hospital stay and presence or absence of post-op complications.
RESULTS
The mean age in the groups was 65.7 (± 7.6) in group 1 vs 64.8 (± 6.8) in group 2. The groups were similar with respect to age, prostate specific antigen, prostate volume, blood loss, duration of surgery, blood transfusion and overall complication rate. However statistically significant differences were observed in clot retention episodes between group 1 and 2: 0.8 (± 1.5) vs 3.5 (± 4.4), P < 0.000, clot retention episodes requiring evacuation with bladder syringe 0.4 (± 0.9) vs 2.6 (± 3.8), P = 0.001, requirement of extra analgesics 0.4 (± 0.5) vs 4.0 (± 1.5), P < 0.000 and duration of admission 8.6 d (± 1.2) vs 7.3 d (± 0.6), P < 0.000.
CONCLUSION
Subjects drained with a combination of urethral and SPCs have fewer clot retention episodes and reduced requirement of extra analgesics but slightly longer hospital stay.
Collapse