Silicone versus polyvinylchloride bladder catheter following radical prostatectomy and postoperative pain: a randomized comparative study

Introduction: Prostate cancer is the most common malignancy in men. In the case of localized prostate cancer, the treatment of choice is radical prostatectomy. Radical prostatectomy creates post-operative pain which is characterized as acute nociceptive resulting from the surgical field and catheter-related bladder discomfort (CRBD) resulting from the indwelling urinary catheter. The purpose of the study was the comparison of the effect of two different types of indwelling bladder catheters on postoperative pain after radical retropubic prostatectomy. Materials and Methods: The study included 120 men with localized prostate cancer who underwent radical retropubic prostatectomy and were randomized into two groups of 60 each. In the first group patients were catheterized with a couvelaire urinary catheter made of polyvinylchloride (couvelaire group) and in the second group patients were catheterized with a silicone catheter (silicone group). Urinary catheterization was performed with a 20Fr catheter and the balloon was inflated with 20ml. All patients received morphine, paracetamol , wound infiltration with ropivacaine and lornoxicam for the treatment of postoperative pain. The grade of postoperative pain was assessed with the numeric rating scale for clinical pain measurement , and the catheter related bladder discomfort was assessed as null, mild, moderate and severe at the 1st, 2nd, 6th, 24th hour, 3rd and 5th day postoperatively. Results: The postoperative pain because of tissue damage was lower in the silicone group than that of the couvelaire group at 6th, 24th hour and 3rd, 5th day postoperatively. (P<0.05). The catheter related bladder discomfort was significantly lower in the silicone group than that of the couvelaire group (P<0.001). Conclusion: The use of urinary catheter made of pure silicone reduced postoperative pain in patients undergoing radical retropubic prostatectomy compared to the use of the couvelaire catheter made of polyvinylchloride.