Abstract

Objectives: The aim of our study was to provide early catheter removal at 8th day after surgery by using introperative bilateral ureteral stents in each ureter.

Material and Methods: In between 1996-2001, radical retropubic prostatectomy was done to 74 patients for localized prostate cancer. Urethral catheters were removed at 8th day after the operation in 34 of 74 patients. Mean age value was 61 (range between 47 and 74). Mean follow-up time was 14 months (6-22 months). All patients were staged according to TNM system with digital rectal examination, PSA, TRUS guided biopsy and Gleason scoring. In the operation, after prostate, seminal vasiculos and lymph nodes were excised, ureteral orifices were pointed in bladder. 90 cm 6 Fr ureteral catheters were placed and taken out from urethra. After 20 F Foley urethral catheter was placed, anostomosis sutures were tied. At seventh day after surgery ureteral catheters were withdrawn and urethral catheter was removed at eight day. Cystrography was done to observe urinary extravasation.

Results: There was no urinary leakage in 32 of 34 (%94.12) patients. Urethral catheter was replaced in 2 patients and removed at 14th day with extravasation. Complications such as urinary retantion, urinoma or pelvic abscess were not seen due to early catheter removal. Wound infection in 2 patients treated with medical care. Patients were followed at 3 months intervals. 5 patients had transient stress incontinence lasting between 3 and 6 month. All patients were continent at 6th month. Maximum flow rate was 14 ml/sec in uroflowmetric examination. Anostomosis stricture was seen in 2 patients (%5.3). Soft dilation and transurethral resection were done to strictures.

Conclusion: Early catheter removal is both possible and confident after radical retropubic prostatectomy. Early removal of urethral catheter did not lead any added complications. Ureter catheters that were placed in operation prevent urinary leakage and pressure and provide confident anostomosis.