Suprapubic prostatectomy with a novel catheter

Area of Science:

• Urology
• Surgical Innovation
• Medical Devices

Background:

• Benign prostatic hyperplasia (BPH) is a common condition in aging men.
• Transurethral prostate resection is the standard surgical treatment for BPH.
• Open prostatectomy remains an option for specific cases.

Purpose of the Study:

• To evaluate the postoperative morbidity and technical complications of a new handmade catheter for suprapubic prostatectomy.
• To compare a novel urethral catheter-free technique with the traditional method.

Main Methods:

• 146 patients with lower urinary tract symptoms underwent either a novel suprapubic prostatectomy (96 patients) using a handmade cystostomy catheter or a traditional procedure (50 patients) with both cystostomy and urethral catheters.
• Postoperative outcomes including clot retention, hemoglobin decrease, irritative symptoms, voiding status, and incontinence were assessed.
• Patients were followed for 3 months with symptom scores, maximum flow rate, and cystoscopic examination.

Main Results:

• The novel catheter group reported no significant irritative urinary symptoms, clot retention, or incontinence.
• Patient satisfaction with voiding was higher in the novel catheter group (94%) compared to controls (86%).
• The novel catheter group had no urinary tract infections or epididymo-orchitis, unlike 8% of controls. Urethral stricture rates were lower (4.1% vs. 14%).

Conclusions:

• Urethral catheter-free suprapubic prostatectomy using a handmade cystostomy catheter is a safe and effective alternative.
• This technique offers a low postoperative risk of infection, incontinence, and stricture formation.
• Open adenomectomy, particularly with this novel catheter, remains a viable surgical option for BPH.