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The impact of time to catheter removal on short-, intermediate- and long-term urinary continence after radical prostatectomy

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Abstract

Purpose

To assess the impact of prolonged catheterization time on 1-week (short-term), 3-month (intermediate-term) and 1-year (long-term) UC.

Methods

Between 2008 and 2015, 6918 men underwent RP by four high-volume surgeons. Exclusion criteria were baseline urinary incontinence (UI) and radiotherapy prior or within 12 months after RP. For the remaining 4111 patients, data on short-, intermediate- and long-term UC were available for 3989, 2490 and 1967 patients, respectively. UC was defined as the use of zero or 1-safety pad/24 h. Time to catheter removal was categorized into  ≤ 7, 8–14 and  ≥ 15 days. To assess the impact of catheterization time on short-, intermediate- and long-term UI, uni- and multivariable logistic regression analyses adjusted for age, BMI, prostate volume, pathological tumor stage, Charlson comorbidity index and nerve-sparing technique were performed.

Results

Post-RP UC rates at 1 week for catheterization of  ≤ 7, 8–14 and ≥ 15 days were 31.2, 27.4 and 18.0%. For the same groups, 3-month and 1-year UC rates were 82.7, 79.2 and 74.1% as well as 90.8, 91.6 and 88.2%, respectively. In multivariate logistic regressions, longer catheterization time was associated with worse short- and intermediate UI (OR 15 days: 2.19 and 1.54; p = ≤ 0.001 and p = 0.04). This difference dissipated at 1 year after RP (p > 0.05).

Conclusions

While longer catheterization is associated with worse short- and intermediate-term UC, it has no adverse impact on long-term UC.

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Funding

Fundings

Nothing to disclose. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Author contribution

DT: protocol/project development, data collection or management, data analysis, and manuscript writing/editing. FP: data collection or management, data analysis, and manuscript writing/editing. PK: protocol/project development, data analysis, and manuscript writing/editing. SFS: protocol/project development and manuscript writing/editing. MG: protocol/project development, data collection or management, and manuscript writing/editing. HH: protocol/project development, data collection or management, and manuscript writing/editing. FKC: protocol/project development, data collection or management, and manuscript writing/editing. RSP: protocol/project development, data collection or management, data analysis, and manuscript writing/editing.

Corresponding author

Correspondence to Derya Tilki.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Tilki, D., Preisser, F., Karakiewicz, P. et al. The impact of time to catheter removal on short-, intermediate- and long-term urinary continence after radical prostatectomy. World J Urol 36, 1247–1253 (2018). https://doi.org/10.1007/s00345-018-2274-y

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  • DOI: https://doi.org/10.1007/s00345-018-2274-y

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