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Side-fenestrated catheter decreases leakage at the urethrovesical anastomosis after robot-assisted laparoscopic radical prostatectomy

Riikonen J, Kaipia A, Matikainen M, Koskimäki J, Kylmälä T, Tammela TL

Scandinavian journal of urology, 2014

108 participants

Abstract

OBJECTIVE: The aim of this study was to analyse whether a side-fenestrated urinary catheter can decrease the frequency of anastomotic leakage after robot-assisted laparoscopic radical prostatectomy (RALP).

MATERIAL AND METHODS: Two-hundred and fifty patients with localized prostate cancer undergoing RALP were randomized into standard and side-fenestrated catheter groups in a prospective randomized study. The catheter was fenestrated at the site of the anastomosis to improve drainage. A cystogram was taken at 7 ± 2 days postoperatively to verify the watertightness of the anastomosis. The patients were monitored for 3 months.

RESULTS: The study included 106 patients with the standard and 108 patients with the fenestrated catheter. Leakage at the urethrovesical anastomosis was found in 13/106 (12.3%) of the standard and 5/108 (4.6%) of the side-fenestrated catheter patients (p = 0.044). Discomfort induced by the catheter and urinary leakage beside the catheter did not differ between the groups. The clinical and pathological characteristics and complications were equal between the groups.

CONCLUSIONS: The side-fenestrated catheter decreased leakage rates at the urethrovesical anastomosis after RALP.

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 108 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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