Suprapubic Tubes May Be Better for RALP Patients

Advantages in terms of bother and pain surface in a prospective randomized trial comparing suprapubic tubes and urethral catheters.
Advantages in terms of bother and pain surface in a prospective randomized trial comparing suprapubic tubes and urethral catheters.

Suprapubic tubes may be a better option than urethral catheters for urinary drainage in patients undergoing robot-assisted laparoscopic prostatectomy (RALP), new study findings suggest.

The prospective randomized study of 62 RALP patients—27 who had a suprapubic tube (SPT) and 35 who had a urethral catheter (UC)—found that bother by the catheter with respect to personal and genital hygiene was significantly less for SPT patients on post-operative day (POD) 5 and POD 1–6, respectively, compared with UC patients.

Catheter-related pain did not differ significantly between the groups except for POD 5 and 6, when the investigators found the SPT to be significantly less bothersome than the UC.

“Consequently, SPT is superior to UC regarding personal and genital hygiene,” Andreas Martinschek, MD, and Daniel Pfalzgraf, MD, of University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany, and colleagues reported in the World Journal of Urology (2016;34:407-411).

Discomfort when going to sleep was significantly less in the SPT group than the UC group on POD 6. Bother when changing clothes was significantly less in the SPT group on POD 3, 5 and 6.

A year after surgery, the researchers observed no significant difference between the groups with respect to urinary function and International Prostate Symptom Score (IPSS).

“The current study is—to our knowledge—the only prospective randomized study to compare UC versus SPT after RALP completely without stenting the anastomosis in the SPT group,” the authors wrote.

The researchers assessed urinary continence and pain with standardized questionnaires: IPSS, IPSS Bother Score, International Index of Erectile Function, and Visual Analogue Scale preoperatively, after catheter removal, and 1 year post-operatively.

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