TY - JOUR
T1 - An Assessment of Patient Comfort and Morbidity after Robot-Assisted Radical Prostatectomy with Suprapubic Tube Versus Urethral Catheter Drainage
AU - Morgan, Monica S.C.
AU - Ozayar, Asim
AU - Friedlander, Justin I.
AU - Shakir, Nabeel
AU - Antonelli, Jodi A.
AU - Bedir, Selahattin
AU - Roehrborn, Claus G.
AU - Cadeddu, Jeffrey A.
N1 - Publisher Copyright:
© Copyright 2016, Mary Ann Liebert, Inc. 2016.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Objective: Robot-assisted laparoscopic prostatectomy (RALP) with suprapubic tube (SPT), compared to urethral catheter (UC) drainage, has been proposed to improve patient comfort and recovery. We sought to compare short-term outcomes for pain and morbidity after RALP with SPT vs UC drainage. Methods: Between August 2012 and 2014, 159 men underwent a RALP and prospectively completed a questionnaire addressing postoperative pain and satisfaction. Group 1 (n = 94) underwent a RALP by one surgeon who placed a UC and removed it between postoperative day (POD) 7 and 10. Group 2 (n = 65) underwent a RALP by a different surgeon who placed an SPT and UC. On POD 1, the UC was removed. On POD 9, the SPT was capped and removed on POD 11 if the patient was voiding adequately. Preoperative and intraoperative data, complications, questionnaires, and patient-reported morbidity, including unplanned telephone calls and emergency department (ED) visits, were compared between groups. Results: Patient characteristics were similar between groups. One week after surgery, the penile pain score was statistically significantly lower in Group 2 compared to Group 1 (56.9% and 79.8%, respectively, reported minimal-to-moderate pain, p = 0.003). Bladder spasms and overall pain were not significantly higher for Group 1 compared to Group 2 (p > 0.05). When asked "How big a problem has your urine storage device been?," 20.2% of patients in Group 1 reported it as a "moderate-to-big" problem compared to 10.8% in Group 2 (p > 0.05). The number of catheter-related unplanned telephone encounters did not differ between the two groups (p = 0.7), however, although not statistically significant, 4.6% of patients in Group 2 presented to the ED with catheter-related issues (p = 0.07). Conclusion: SPT after RALP was associated with less penile pain compared to UC drainage, and modestly better patient satisfaction. There were no significant differences in bladder spasms, overall pain, and patient-reported morbidity between groups.
AB - Objective: Robot-assisted laparoscopic prostatectomy (RALP) with suprapubic tube (SPT), compared to urethral catheter (UC) drainage, has been proposed to improve patient comfort and recovery. We sought to compare short-term outcomes for pain and morbidity after RALP with SPT vs UC drainage. Methods: Between August 2012 and 2014, 159 men underwent a RALP and prospectively completed a questionnaire addressing postoperative pain and satisfaction. Group 1 (n = 94) underwent a RALP by one surgeon who placed a UC and removed it between postoperative day (POD) 7 and 10. Group 2 (n = 65) underwent a RALP by a different surgeon who placed an SPT and UC. On POD 1, the UC was removed. On POD 9, the SPT was capped and removed on POD 11 if the patient was voiding adequately. Preoperative and intraoperative data, complications, questionnaires, and patient-reported morbidity, including unplanned telephone calls and emergency department (ED) visits, were compared between groups. Results: Patient characteristics were similar between groups. One week after surgery, the penile pain score was statistically significantly lower in Group 2 compared to Group 1 (56.9% and 79.8%, respectively, reported minimal-to-moderate pain, p = 0.003). Bladder spasms and overall pain were not significantly higher for Group 1 compared to Group 2 (p > 0.05). When asked "How big a problem has your urine storage device been?," 20.2% of patients in Group 1 reported it as a "moderate-to-big" problem compared to 10.8% in Group 2 (p > 0.05). The number of catheter-related unplanned telephone encounters did not differ between the two groups (p = 0.7), however, although not statistically significant, 4.6% of patients in Group 2 presented to the ED with catheter-related issues (p = 0.07). Conclusion: SPT after RALP was associated with less penile pain compared to UC drainage, and modestly better patient satisfaction. There were no significant differences in bladder spasms, overall pain, and patient-reported morbidity between groups.
KW - Aged
KW - Cystostomy/methods
KW - Drainage
KW - Humans
KW - Laparoscopy
KW - Male
KW - Middle Aged
KW - Morbidity
KW - Pain, Postoperative/epidemiology
KW - Patient Satisfaction
KW - Postoperative Complications/epidemiology
KW - Prostatectomy/methods
KW - Prostatic Neoplasms/surgery
KW - Retrospective Studies
KW - Robotic Surgical Procedures/methods
KW - Surveys and Questionnaires
KW - Urinary Catheterization/methods
KW - Urinary Catheters
UR - http://www.scopus.com/inward/record.url?scp=84960871069&partnerID=8YFLogxK
U2 - 10.1089/end.2015.0206
DO - 10.1089/end.2015.0206
M3 - Article
C2 - 26472083
AN - SCOPUS:84960871069
SN - 0892-7790
VL - 30
SP - 300
EP - 305
JO - Journal of Endourology
JF - Journal of Endourology
IS - 3
ER -