Appropriateness Criteria for Catheter Management after TURP

• 10 Mar 2020 11:22:23 AM
• |Endo Urology

Dear All,

There is no definitive Guidelines available world over as how long to retain catheter after TURP. Most of the decisions are institution centric which varies considerably.

I would appreciate our members to help us know as regards this as what their policy for catheter duration should be. It is easy to borrow from the appropriateness statement sent but this being a practical issue, everyone, as mentioned have their own views. It is not necessary that we ape the west but can form our own criteria regarding such a common problem.

I am providing the link for ‘Appropriateness Criteria for Catheter Management after TURP’

https://www.ajmc.com/journals/issue/2019/2019-vol25-n12/catheter-management-after-benign-transurethral-prostate-surgery-randucla-appropriateness-criteria

With warm regards,

Venu

Comments(3)

• 

  Ashish parikh

  10 Mar 2020 04:31:07 PM

  Respected Professor Dr. Venugopal sir,

  Thanks for sharing good article, to learn with others experience.

  We generally remove catheter in POST TURP: (our protocol).

  Mono/Bipolar TURP: - 3rd POD( initially on 4th POD, we removed the catheter, nowadays on 3rd day).

  HOLEP: after 24 hours.

  i read few articles,and likes to share with this group,  and again thanks to you sir, because of u ask the question and i inspired to read it . 

  Studies shows that short term catheterisation is best to prevent UTI and stricture in TURP pts.

  Thank you sir.

  
  

  View DocumentView DocumentView Document

• 

  Venugopal P

  10 Mar 2020 06:12:37 PM

  Dear Ashish,

  Thank you for the articles provided. No doubt all of us are sure that early catheter removal after TURP Mono or Bipolar/Laser Treatments are the way to go about. But in practice, somehow we never follow what we preach. There cannot be a definitive rule as circumstances change from case to case and hence one cannot have a rule of thumb as how long a catheter should be placed in situ after such procedures. In the article provided. It is a general rule but mention that recatheterization or intermittent catheterisation may be required in those who do not void on catheter removal.

  There are now several articles addressing that these procedures can be performed on day care basis. Maybe some even in India are performing such procedures as day care. In India, most of our patients are not happy if they are informed that they can leave the premises of the hospital the same day and most want complete, what they assume cure, prior to leaving for home. A Point that should be kept in mind is of litigation. If the patient is sent home and develops retention, we have enough lawyers who could advice them to sue for improper treatment. I had to give evidence for a colleague of mine under such a situation.

  The guidelines are plenty. The desire to follow them is infinite. But remember in whatever you do or practice, you have to follow ‘Primum Non Nocere’ and also remember ‘do unto others as you would have them do unto you’.

  With warm regards,

  Venu

   

• 

  Dr. Roy Chally

  10 Mar 2020 09:06:23 PM

  The heading of the article is misleading as other techniques such as ablation of prostate etc are clubbed with TURP. I remember Dr Thilak from Bombay presenting a paper on catheter removal on day 1 after TURP a long time back in USI. I also remember Dr Colabawala’s criticism. 

        Pain with voiding will be more when cath is removed on day one after TURP. With pain chances of straining during voiding is high. This and the standing position to void will raise the venous pressure in veins in prostate bed. As a result the incidence of bleeding with clots is going to be high in TURP when catheter is removed on day 1.