TRANSURETHRAL RESECTION OF PROSTATE: EARLY VERSUS DELAYED REMOVAL OF CATHETER
Abstract
Background: Transurethral resection of prostate is the gold standard operation for bladder outflow obstruction due to benign prostatic enlargement. However, catheter removal day is variable. The objective of this study was to compare early and delayed catheter removal groups in terms of length of hospital stay, weight of resected prostate, duration of resection, peri-operative blood transfusion, and postoperative complications. Methods: This randomized controlled trial was carried out in Urology Unit-B, Institute of Kidney Diseases Peshawar from 1st September 2009 to 31st July 2011. Patients were selected by simple random sampling technique after taking informed consent and divided into two groups: Group A-standard catheter removal group and Group B-early catheter removal group. The study excluded patients with large post-void urine volume, simultaneous internal urethrotomy and transurethral resection of prostate, co-morbidity and intra-operative complications. Patients were discharged after removal of catheter if they voided successfully. In Group-A the catheters were kept for more than one day according to the standard protocol of our ward. The data were analysed using SPSS-17. Results: The study included 320 patients, 163 in Group-A and 157 in Group-B. Mean weight of resected tissue in Group-A was 46.67±9.133 grams; it was 45.22±7.532 grams in group B. Mean catheter removal day was 4.13±1.65days in Group-A; and 1.23±0.933 days in Group-B. Mean length of hospital stay was 3.57 days±1.028 in Group-A and 1.29 days±1.030 in Group-B (p-value<0.05). Length of hospital stay strongly correlated with the day of catheter removal. There was no significant difference between the two groups in terms of postoperative complications. Conclusion: Removal of catheter on first postoperative day after transurethral prostatectomy does not increase the postoperative complications and results in shorter hospital stay.
Keywords: Transurethral resection of prostate, urinary catheterization, postoperative complicationsReferences
Starkman JS, Santucci RA. Comparison of bipolar transurethral resection of the prostate with standard transurethral prostatectomy: shorter stay, earlier catheter removal and fewer complications. BJU Int 2005;95:69-71.
Das Bhagia S, Mahmud SM, El Khalid S. Is it necessary to remove Foleys catheter late after Transurethral Prostatectomy in patients who presented with Acute Urinary Retention secondary to Benign Prostatic Hyperplasia? J Pak Med Assoc 2010;60:739-40.
Nakagawa T, Toguri AG. Early catheter removal following transurethral prostatectomy: A study of 431 patients. Med Princ Pract 2006;15:126-30.
McDonald CE, Thompson JM. A comparison of midnight versus early morning removal of urinary catheters after transurethral resection of the prostate. J Wound Ostomy Continence Nurs 1999;26:94-7.
Ganta SB, Chakravarti A, Somani B, Jones MA, Kadow K. Removal of catheter at midnight versus early morning: the patients' perspective. Urol Int 2005;75:26-9.
Chalise PR, Agrawal CS, Pandit RK. Reduction of length of hospital stay after transurethral resection of prostate by early catheter removal: a retrospective analysis. Nepal Med Coll J 2007;9:84-7.
Agarwal SK, Kumar AS. Early removal of catheter following transurethral resection of the prostate. Br J Urol 1993;72:928-9.
Mamo GJ, Cohen SP. Early catheter removal vs. conventional practice in patients undergoing transurethral resection of prostate. Urology 1991;37:519-22.
Perera ND, Nandasena AC. Early catheter removal after transurethral resection of the prostate. Ceylon Med J 2002;47:11-2.
Mueller EJ, Zeidman EJ, Desmond PM, Thompson IM, Optenberg SA, Wasson J. Reduction of length of stay and cost of transurethral resection of the prostate by early catheter removal. Br J Urol 1996;78:893-6.
Aslan G, Çelebi I, Arslan D, Esen AA. Early Catheter Removal following Transurethral Prostatectomy: Overnight Catheterization. Urol Int 2002;68:105-8.
Kirollos MM. Length of postoperative hospital stay after transurethral resection of the prostate. Ann R Coll Surg Engl 1997;79:284-8.
Ozden C, Gunay I, Deren T, Bulut S, Ozdal OL, Koparal S, Memis A. Effect of transurethral resection of prostate on prostatic resistive index. Urol Int 2010;84:191-3.
Gupta NP, Singh A, Kumar R. Transurethral vapor resection of prostate is a good alternative for prostates >70 g. J Endourol 2007;21:1543-6.
Persu C, Georgescu D, Arabagiu I, Cauni V, Moldoveanu C, Geavlete P. TURP for BPH. How Large is Too Large? J Med Life 2010;3:376-80.
Ahmad M, Husain S, Abbas S, Iqbal N, Tahir M, Nasrullah F. Transuretheral resection of prostate (TURP) -A treatment modality for benign prostatic hyperplasia (BPH). Ann King Edward Med Uni 2004;10:152-4.
Alhasan SU, Aji SA, Muhammed AZ, Malami S. Transurethral resection of the prostate in Northern Nigeria, problems and prospects. BMC Urol 2008;8:18.
Elbadawi A, Yalla SV, Resnick NM. Structural basis of geriatric voiding dysfunction. II Aging detrusor: normal versus impaired contractility. J Urol 1993;150:1657-67.
Downloads
Published
How to Cite
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.