Articles

Prostate Cancer

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

By: Motoo Araki, Murugesan Manoharan, Sachin Vyas, Alan M. Nieder and Mark S. Soloway lowast

European Urology, Volume 50 Issue 1, December 2006, Pages 1241-1247

Published online: 01 December 2006

Keywords: Prostate cancer, Prostatic neoplasms, Radical prostatectomy, Drainage, Surgery

Abstract Full Text Full Text PDF (129 KB)

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.

Take Home Message

If the bladder neck is preserved or meticulously reconstructed, routine drainage is unnecessary. Our 4-year experience (552 cases) indicates that morbidity is not increased by omitting a drain from the pelvic cavity after radical retropubic prostatectomy in properly selected cases.

Keywords: Prostate cancer, Prostatic neoplasms, Radical prostatectomy, Drainage, Surgery.

Footnotes

Department of Urology, Miller School of Medicine, University of Miami, Miami, Florida, USA

lowast Corresponding author. Department of Urology, University of Miami School of Medicine, PO Box 016960 (M814), Miami, FL 33101, USA. Tel. +1 305 243 6596; Fax: +1 305 243 4653.

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