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Percutaneous suprapubic tube bladder drainage after robot‐assisted radical prostatectomy: a step‐by‐step guide
Author(s) -
Ghani Khurshid R.,
Trinh QuocDien,
Sammon Jesse D.,
Jeong Wooju,
Simone Andrea,
Dabaja Ali,
Dusik Stacey,
Peabody James O.,
Me Mani
Publication year - 2013
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.12071
Subject(s) - medicine , surgery , percutaneous , prostatectomy , foley catheter , fibrous joint , catheter , abdominal wall , prostate , cancer
Objective To describe our technique of maintaining bladder drainage after robot‐assisted radical prostatectomy ( RARP ) using a percutaneous suprapubic tube ( PST ) in place of a urethral catheter.Methods A watertight anastomosis permits placement of the PST . Contraindications include morbid obesity, concomitant inguinal hernia mesh repair, anticoagulation therapy, limited hand dexterity in the patient, bladder neck reconstruction and extensive adhesiolysis at RARP . The necessary equipment includes a 14‐ F PST balloon catheter set, a three‐way connector, a connecting tube, a suture passer, 1/0 polypropylene sutures on a CT 1 needle, a sterile plastic button, adhesive and steri‐strips.Results The important steps for PST placement are: Step 1: robot‐assisted placement of a bladder wall anchor suture; Step 2: transferring the bladder wall suture to anterior abdominal skin; Step 3: guided placement of the PST under robotic vision; Step 4: securing the PST within the bladder and abdominal wall; Step 5. postoperative care: clamping the PST on postoperative day 5, recording each void and post‐void residual urine volumes in a patient diary, removal of the PST on postoperative day 7 after 48 h of voiding with residual urine <100 mL per void.Conclusion We provide a concise step‐by‐step guide for placement of a PST during RARP as well as important management aspects for the successful adoption of this technique.