Korean J Urol.  2013 Jan;54(1):31-35.

Risk Factors for Failure of Early Catheter Removal After Greenlight HPS Laser Photoselective Vaporization Prostatectomy in Men With Benign Prostatic Hyperplasia

• Bae WJ
• Ahn SG
• Bang JH
• Bae JH
• Choi YS
• Kim SJ
• Cho HJ
• Hong SH
• Lee JY
• Hwang TK
• Kim SW

Abstract

PURPOSE
To assess the risk factors for developing urinary retention after removal of the urethral catheter on postoperative day 1 in benign prostatic hyperplasia patients who underwent Greenlight HPS laser photoselective vaporization prostatectomy (PVP).
MATERIALS AND METHODS
The study included 427 men who underwent Greenlight HPS laser PVP between 2009 and 2012, excluding patients in whom a catheter was maintained for more than 1 day because of urethral procedures. In all patients, a voiding trial was performed on postoperative day 1; if patients were unable to urinate, the urethral catheter was replaced before hospital discharge. The patients were divided into two groups: early catheter removal (postoperative day 1) and late catheter removal (urethral catheter reinsertion). Preoperative and perioperative parameters were compared between the groups.
RESULTS
Catheters were successfully removed in 378 (88.6%) patients on postoperative day 1. In 49 patients, the catheters were reinserted and removed a mean of 6.45+/-0.39 days after surgery. In a multivariate analysis, a history of diabetes was the most significant predictor (p=0.028) of failure of early catheter removal, followed by operative time (p=0.039). There were no significant differences in age, prostate volume, International Prostate Symptom Score, or urodynamic parameters between the two groups.
CONCLUSIONS
It is feasible, safe, and cost-effective to remove the urethral catheter on postoperative day 1 after Greenlight HPS laser PVP, but the procedure should be done carefully in patients who have history of diabetes or an extended operative time.

Keyword

Laser therapy; Prostatic hyperplasia; Urethral catheterization

MeSH Terms

Catheters
Humans
Laser Therapy
Male
Multivariate Analysis
Operative Time
Prostate
Prostatectomy
Prostatic Hyperplasia
Risk Factors
Urinary Catheterization
Urinary Catheters
Urinary Retention
Urodynamics
Volatilization

Reference

1. Roehrborn CG, McConnell J, Bonilla J, Rosenblatt S, Hudson PB, Malek GH, et al. Serum prostate specific antigen is a strong predictor of future prostate growth in men with benign prostatic hyperplasia. PROSCAR long-term efficacy and safety study. J Urol. 2000. 163:13–20.

2. Stovsky MD, Griffiths RI, Duff SB. A clinical outcomes and cost analysis comparing photoselective vaporization of the prostate to alternative minimally invasive therapies and transurethral prostate resection for the treatment of benign prostatic hyperplasia. J Urol. 2006. 176(4 Pt 1):1500–1506.

3. Al-Ansari A, Younes N, Sampige VP, Al-Rumaihi K, Ghafouri A, Gul T, et al. GreenLight HPS 120-W laser vaporization versus transurethral resection of the prostate for treatment of benign prostatic hyperplasia: a randomized clinical trial with midterm follow-up. Eur Urol. 2010. 58:349–355.

4. Agrawal SK, Kumar AS. Early removal of catheter following transurethral resection of the prostate. Br J Urol. 1993. 72:928–929.

5. Drago JR. Transurethral incision of prostate. Urology. 1991. 38:305–306.

6. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002. 21:167–178.

7. Spaliviero M, Araki M, Wong C. Short-term outcomes of Greenlight HPS laser photoselective vaporization prostatectomy (PVP) for benign prostatic hyperplasia (BPH). J Endourol. 2008. 22:2341–2347.

8. Araki M, Lam PN, Wong C. High-power potassium-titanyl-phosphate laser photoselective vaporization prostatectomy for symptomatic benign prostatic hyperplasia. J Endourol. 2008. 22:1311–1314.

9. Bouchier-Hayes DM, Anderson P, Van Appledorn S, Bugeja P, Costello AJ. KTP laser versus transurethral resection: early results of a randomized trial. J Endourol. 2006. 20:580–585.

10. Van Cleynenbreugel B, Srirangam SJ, Van Poppel H. High-performance system GreenLight laser: indications and outcomes. Curr Opin Urol. 2009. 19:33–37.

11. Sandhu JS, Ng CK, Gonzalez RR, Kaplan SA, Te AE. Photoselective laser vaporization prostatectomy in men receiving anticoagulants. J Endourol. 2005. 19:1196–1198.

12. Cherrie RJ, Young RA, Cattolica EV. The safety of overnight hospitalization for transurethral prostatectomy: a prospective study of 200 patients. J Urol. 1997. 157:531–533.

13. Gu X, Strom K, Spaliviero M, Wong C. Intermediate outcomes of GreenLight HPS™ laser photoselective vaporization prostatectomy for symptomatic benign prostatic hyperplasia. J Endourol. 2011. 25:1037–1041.

14. Nakagawa T, Toguri AG. Early catheter removal following transurethral prostatectomy: a study of 431 patients. Med Princ Pract. 2006. 15:126–130.

15. 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. 60:739–741.

16. Kaplan SA, Te AE, Blaivas JG. Urodynamic findings in patients with diabetic cystopathy. J Urol. 1995. 153:342–344.

17. Daneshgari F, Liu G, Birder L, Hanna-Mitchell AT, Chacko S. Diabetic bladder dysfunction: current translational knowledge. J Urol. 2009. 182:6 Suppl. S18–S26.