MP51-08 FACTORS LEADING TO PROLONGED CATHETER TIME AFTER LAPAROSCOPIC AND ROBOTIC-ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY

INTRODUCTION AND OBJECTIVES: On day 7 after laparoscopic radical prostatectomy (LRP) / robotic-assisted LRP (RALP), we usually do a cystogram and remove the foley catheter when watertightness of the anastomosis is shown. Prolonged catheter time is defined as necessity to leave the catheter due to leakage in this first cystogram. In these patients, a second cystogram is performed 10-14 days after surgery to re-access the anastomosis. The objective of this study is to investigate the occurrence of prolonged catheter time in a large single-institutional cohort and to identify parameters leading to prolonged catheter time. METHODS: Time to removal of the catheter was available in 2772 of the 2800 first consecutive patients who underwent LRP / RALP in our institution. Univariate and multivariate logistic regression models were used to investigate the relationship between operative parameters / patient characteristics and prolonged catheter time. RESULTS: Mean time to catheter removal was 12.1 days, standard deviation 9.3 days, median 7 days. The difference between the first 700 patients (mean time to catheter removal 13.9 days) and the last 700 (mean time 9.8 days) was statistically significant (p 4 hours as significant predictors of prolonged catheter time (p < 0.05). Other factors (surgeon, use of the robot, use of the Rocco stitch, weight of the prostate, Gleason score, previous transurethral resection of the prostate) showed significance in univariate, but not in multivariate analysis. Age, body mass index and pathological tumor stage had no significant impact on catheter time. CONCLUSIONS: The operative technique is the key factor to achieve a short catheter time after LRP / RALP. A running suture for vesicourethral anastomosis, nerve sparing and bladder neck sparing technique, watertightness of the anastomosis during surgery and a short operating room time showed significant influence. Catheter time is neither depending on patient characteristics (age, weight, size of the prostate), nor on pathological characteristics.