Eddy Lilly, Dimitrios Papadopoulos, Konstantinos Pagonis, Danny Carbin Darlington, Venkata Murthy Kusuma, Matthew Perry, Dimitrios Moschonas, Wissam Abou Chedid
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引用次数: 0
Abstract
Introduction and objectives: We conducted a prospective audit to evaluate the feasibility of suprapubic catheter self-removal and what factors can interfere with the decision of self-removal, in post RS-RARP patients.
Material and methods: Forty-four patients had a SPC inserted following a RS-RARP from January 2024 until May 2024, 36 of them opted for self-removal. Feedback was obtained 4 weeks post operatively regarding catheter related symptoms and the complexity of self-removal procedure.
Results: Most patients reported minimal overall pain (median = 2), with penile pain most frequently rated as none (mode = 1). Bladder cramps and overall problem perception were also low (median = 1); 65.9% of patients reported no bladder cramps, and 61.4% had no issues with SPC management. Factors such as overall pain (p = 0.234), penile pain (p = 0.286), and overall problem perception (p = 0.643) did not significantly influence the decision of SPC self-removal. However, bladder cramp frequency had impacted the self-removal decision (p = 0.029). The majority (80.6%) found self-removal easy, with only 11.1% considering it complicated. Most patients also recommended self-removal, reinforcing its overall feasibility. The perceived complexity of self-removal was associated with likelihood to recommend the procedure (p < 0.001). Additionally, penile pain correlated with bladder cramps (p = 0.006) and overall problem perception (p = 0.003), suggesting discomfort in one area may reflect a broader negative experience affecting patients' decision making regarding self-removal, as patients with higher bladder cramps were less likely to recommend self-removal (p = 0.008).
Conclusion: SPC self-removal after RS-RARP appeared feasible and acceptable in a selected group of patients supported by structured education and specialist nurse follow-up. These findings should be interpreted cautiously given the small single-center sample, absence of randomization, and use of a non-validated questionnaire. Further comparative studies are required before wider implementation can be recommended.
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