A urethral catheter is a thin tube that is inserted into the penis and up into the urethra to drain urine from the body. It is often uncomfortable, sometimes painful, and patients do not like to go home using the catheter.
In Birmingham Prostate Clinic, we have introduced a new approach, first developed in America by the urologist Mani Menon, allowing patients to go home catheter-free.
It is based on the use of a drain inserted through the lower abdomen, called a suprapubic catheter during surgery. This is much more comfortable than a urethral catheter.
Allows us to remove the urethral catheter in only 12 hours of surgery. The urethral catheter is necessary for the immediate hours after surgery, to ensure a urinary flow and may continue.
The suprapubic catheter remains in place to alleviate the pressure while the patient regains control and the ability to empty normally.
Only patients who have a perfect anastomosis (reconnection between the bladder and urethra after prostatectomy) are suitable for this technique. Over 80 percent of patients will be suitable and able to leave the hospital without a catheter.
For most patients, the suprapubic catheter can be removed at 48 hours post surgery.
This is important because after a keyhole prostatectomy, patients often go home in two days after surgery.
It makes a huge difference can download free from a patient in a catheter, compared with leaving them with a catheter for a week.
This innovation is only possible because the use of less invasive surgery, keyhole, causing less disruption between the bladder and urethra when removing the prostate. We are able to achieve a much better again, known as an anastomosis between the urethra and bladder and patients, this means regaining control over rapidly.
Catheter free download is a new evolution and development, but research suggests that the United States is very efficient and offers clear benefits for patients.
A British study published in the Journal of Urology International (September 2008) reports of patients using the new device for bladder drainage had practically none of the pain associated with a conventional urethral catheter.
Ashutosh Tewari, MD, of Weill Cornell Medical College found free catheter drainage of the bladder was also associated with less discomfort while sleeping and walking, and fewer episodes of bladder spasm.
"Urethral catheter-less robotic radical prostatectomy is feasible, with the advantages of the decline shaft and the tip of the penis and decrease the pain and discomfort of the patient prior to return of continence," concluded the authors. "In this pilot study there was no late-term complications such as bladder neck contracture.
Notably go home catheter-free is not possible for all patients. Some patients have not been prepared for their catheters removed at 12 and then to 48 hours and not be suitable for this approach.
But we believe the catheter-free approach will be adequate for about 80 percent of prostatectomy patients.
Often, when discussing the evolution of surgery, are based on expensive, hi-tech solutions. Here we have a relatively simple method that has the potential to make a huge difference to the experience of thousands of patients who have prostate surgery each year.
This new approach is very important because it is based on a real understanding of patient experience of a prostatectomy, and is designed to improve that experience.
In Birmingham Prostate Clinic, we have introduced a new approach, first developed in America by the urologist Mani Menon, allowing patients to go home catheter-free.
It is based on the use of a drain inserted through the lower abdomen, called a suprapubic catheter during surgery. This is much more comfortable than a urethral catheter.
Allows us to remove the urethral catheter in only 12 hours of surgery. The urethral catheter is necessary for the immediate hours after surgery, to ensure a urinary flow and may continue.
The suprapubic catheter remains in place to alleviate the pressure while the patient regains control and the ability to empty normally.
Only patients who have a perfect anastomosis (reconnection between the bladder and urethra after prostatectomy) are suitable for this technique. Over 80 percent of patients will be suitable and able to leave the hospital without a catheter.
For most patients, the suprapubic catheter can be removed at 48 hours post surgery.
This is important because after a keyhole prostatectomy, patients often go home in two days after surgery.
It makes a huge difference can download free from a patient in a catheter, compared with leaving them with a catheter for a week.
This innovation is only possible because the use of less invasive surgery, keyhole, causing less disruption between the bladder and urethra when removing the prostate. We are able to achieve a much better again, known as an anastomosis between the urethra and bladder and patients, this means regaining control over rapidly.
Catheter free download is a new evolution and development, but research suggests that the United States is very efficient and offers clear benefits for patients.
A British study published in the Journal of Urology International (September 2008) reports of patients using the new device for bladder drainage had practically none of the pain associated with a conventional urethral catheter.
Ashutosh Tewari, MD, of Weill Cornell Medical College found free catheter drainage of the bladder was also associated with less discomfort while sleeping and walking, and fewer episodes of bladder spasm.
"Urethral catheter-less robotic radical prostatectomy is feasible, with the advantages of the decline shaft and the tip of the penis and decrease the pain and discomfort of the patient prior to return of continence," concluded the authors. "In this pilot study there was no late-term complications such as bladder neck contracture.
Notably go home catheter-free is not possible for all patients. Some patients have not been prepared for their catheters removed at 12 and then to 48 hours and not be suitable for this approach.
But we believe the catheter-free approach will be adequate for about 80 percent of prostatectomy patients.
Often, when discussing the evolution of surgery, are based on expensive, hi-tech solutions. Here we have a relatively simple method that has the potential to make a huge difference to the experience of thousands of patients who have prostate surgery each year.
This new approach is very important because it is based on a real understanding of patient experience of a prostatectomy, and is designed to improve that experience.
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