A Pelvic Drain Can Often Be Avoided After Radical Retropubic Prostatectomy-An Update in 552 Cases

Motoo Araki, Murugesan Manoharan, Sachin Vyas, Alan M. Nieder, Mark S. Soloway

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Objectives: The routine placement of a pelvic drain following radical retropubic prostatectomy (RRP) may not be required. We describe our experience in 552 consecutive RRPs to emphasise the safety of this approach and explain our rationale for avoiding a drain when possible. Methods: RRP was performed in 552 consecutive patients with clinically localised adenocarcinoma of the prostate between January 2002 and June 2005. Clinical and pathologic information was documented for each patient. After the prostate was removed and the anastomotic sutures tied, the bladder was gently filled with approximately 50 ml of saline through the urethral catheter. If there was no leak, a drain was not placed. Results: A drain was not placed in 419 (76%) of the 552 patients. We compared the postoperative complication rates in those with (D+) and without (D-) a drain. There were 27 (5%) immediate postoperative complications and no significant difference between the two groups (D+, 6%; D-, 5%; p = 0.629): three (1%) patients who did not have a drain had a urinoma, one (1%) who had a drain had a lymphocele, and two (2%) who had a drain had a small pelvic haematoma. Conclusions: If the bladder neck is preserved or meticulously reconstructed, there may be little extravasation and, thus, routine drainage is unnecessary. Our 4-year experience indicates that morbidity is not increased by omitting a drain from the pelvic cavity after RRP in properly selected cases.

Original languageEnglish
Pages (from-to)1241-1247
Number of pages7
JournalEuropean Urology
Volume50
Issue number6
DOIs
Publication statusPublished - Dec 1 2006
Externally publishedYes

Keywords

  • Drainage
  • Prostate cancer
  • Prostatic neoplasms
  • Radical prostatectomy
  • Surgery

ASJC Scopus subject areas

  • Urology

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