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