CYSTOGRAPHY AFTER RADICAL RETROPUBIC PROSTATECTOMY - CLINICAL IMPLICATIONS OF ABNORMAL FINDINGS

Objectives. In many institutions, cystography is obtained routinely af ter radical retropubic prostatectomy to assess the integrity of the ve sicourethral anastomosis before the removal of the catheter, This stud y presents the Indiana experience with cystograms performed following radical retropubic prostatectomy, Methods, The experience with 260 cys tograms performed in 245 consecutive patients following radical retrop ubic prostatectomy was reviewed retrospectively, with a special refere nce to the clinical implications of abnormal findings. Results. After a standard catheterization period of 14 to 21 days (mean, 19.2), 94.3% of the catheters were removed safely without adverse clinical consequ ences. The presence of a minimal contained contrast extravasation did not affect outcome after the removal of the catheter, The overall inci dence of clinically significant extravasation was found to be 5.7% and was further reduced to 2.4% if extravasation was not suggested clinic ally in the postoperative course,Conclusions. Based on the current lit erature, significant extravasation is a common finding during the firs t 5 to 8 postoperative days, Therefore, management strategies advocati ng early urethral catheter removal should include routine cystographic studies. Otherwise, cystographic confirmation of anastomotic integrit y before the removal of the catheter following 14 to 21 days of cathet erization is not indicated in the routine postradical prostatectomy pa tient.