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Título

FEASIBILITY OF FIRST POSTOPERATIVE DAY FOLEY CATHETER REMOVAL AFTER ROBOTIC ASSISTED LAPAROSCOPIC PROSTATECTOMY

Resumo

Introduction: Technical modifications that can improve patient satisfaction without compromising the surgical and oncological outcomes might be attempted in robotic assisted laparoscopic prostatectomy (RARP). Herein, we describe our initial experience with postoperative day (POD) 1 foley removal after RARP.
Materials and Methods: From January 2020 to June 2020 we enrolled 22 selected patients who were motivated to undergo earlier catheter removal after RARP, defined as removal of the foley catheter within the POD 1. USC’s ERAs RARP protocol was utilized with the add of tamsulosin 0.4mg the night before surgery and maintained for 7 days after catheter removal. Patient data were collected until September 1 2020 for the purposes of this study. On POD 10-14, patients either returned to clinic or were evaluated using a tele-medicine platform. Patients were contacted at baseline, 1 month and 3 months after surgery. Continuous variables were reported as mean and median.
Results: Median follow up was 168 days. All patients tolerated perioperative ERAS medications. Median age was 62 years. Median BMI was 25.5 kg/m2. Median PSA was 7. Median pathologic Gleason score was 3+4. Median operative time was 140 min. No blood transfusions were required. Median time to catheter withdrawal was 23 hours. All patients initially passed the voiding trial. One patient required urinary catheterization after AUR 3 hours after successful voiding trial while still in the hospital. Median hospital stay was 44 hours. Three patients (13%) had a positive margin. Eighteen patients (82%) achieved immediate continence while twenty patients were continent at the end of the follow-up. Seventeen (77.3%) patients had erection function return at the end of the follow up.
Conclusion: Careful patient selection, motivated patient, pre-operative counseling to appropriately set expectations and proactive early post-operative monitoring are essential for good clinical outcomes and patient satisfaction. Our initial experience with POD 1 foley removal after RARP is safe and promising.

Palavras Chave ( separado por ; )

robotic prostatectomy, catheter removal, continence, urinary retention