Year : 2016 | Volume
: 32 | Issue : 2 | Page : 120--123
Selective indication for check cystogram before catheter removal following robot assisted radical prostatectomy
Rajiv Yadav, Somendra Bansal, Narmada P Gupta
Department of Urology, Institute of Kidney and Urology, Medanta - The Medicity, Gurgaon (Delhi, NCR), Haryana, India
Introduction: With the improvement in anastomotic technique, it is rare to find anastomotic site leak after robot-assisted radical prostatectomy (RARP). It may not always be necessary to do regular check cystogram before catheter removal. We evaluated our 230 consecutive RARP patients and their cystograms to determine the indications for selective use of cystogram before catheter removal.
Materials and Methods: We reviewed our prospectively collected RARP database of 230 consecutive patients. Cystography was performed at low pressure by gravity instillation of diluted contrast through the catheter. Patients were observed under fluoroscopy in lateral oblique position for any contrast leak at the site of anastomosis. All patients were followed for a minimum of 6 months, and the longest follow-up was 5 years.
Results: A total of 207 patients (90%) underwent catheter removal on postoperative day 7. Nine patients (3.9%) had extravasation on initial cystogram. Two patients with leak had a history of transurethral resection of prostate (TURP) and seven other had bladder neck reconstruction for wide bladder neck. Three patients with minimal leak did not require catheter replacement. In rest of the 6 patient with leak, continued catheter drainage was done. No significant difference in the intraoperative variables, blood loss, duration of drain, length of hospital stay, and continence outcomes was noted between the patients with leak compared to rest of the patients. None of the patient needed any procedure/intervention related to the surgery and none developed bladder neck stenosis.
Conclusion: In usual circumstances, catheter removal can be done safely on a postoperative day 7 without routine cystography. Selective use of check cystogram can be done in the case where bladder neck reconstruction is performed or those had a prior TURP and a wide bladder neck.
Senior Consultant, Urologic Oncologic and Robotic Surgery Institute of Kidney and Urology, Medanta - The Medicity, Sector 38, Gurgaon (Delhi, NCR), Haryana
|How to cite this article:|
Yadav R, Bansal S, Gupta NP. Selective indication for check cystogram before catheter removal following robot assisted radical prostatectomy.Indian J Urol 2016;32:120-123
|How to cite this URL:|
Yadav R, Bansal S, Gupta NP. Selective indication for check cystogram before catheter removal following robot assisted radical prostatectomy. Indian J Urol [serial online] 2016 [cited 2021 Jan 16 ];32:120-123
Available from: https://www.indianjurol.com/article.asp?issn=0970-1591;year=2016;volume=32;issue=2;spage=120;epage=123;aulast=Yadav;type=0