Early removal of the catheter after laparoscopic radical prostatectomy

Purpose: We prospectively tested the safety of routine removal of the cathe ter as early as 2 to 4 days after laparoscopic radical prostatectomy. Materials and Methods: Between March 1998 and March 2001, 228 patients unde rwent laparoscopic radical prostatectomy for clinically organ confined pros tate cancer. The last 113 consecutive patients were included in a prospecti ve study according to gravitational cystography performed 2 to 4 days posto peratively. If no leak was seen the catheter was removed. If a leak was app arent the catheter was left indwelling for another 6 days and cystography w as repeated. Results: Cystography 2 to 4 days postoperatively showed an anastomosis with out a leak in 96 (84.9%) patients who subsequently had the catheters remove d. There were 28 patients who had the catheter removed on postoperative day 2, 28 day 3 and 40 day 4. In 17 (15.1%) patients an anastomotic leak was o bserved, and the catheter was not removed at that time. Of the 96 patients in whom the catheter was removed early 10 (10.4%) had urinary retention tha t necessitated re-catheterization. This procedure was performed without the need for cystoscopy, After the catheter was removed all patients were able to void 24 hours later. Median followup was 7 months (range 1 to 15) and s howed continence rates greater than 93%. No anastomotic stricture, pelvic a bscess or urinoma developed in any patient. Conclusions: Patients who undergo laparoscopic radical prostatectomy can ha ve the catheter safely removed 2 to 4 days postoperatively without a higher risk of incontinence, stricture or leak related problems.