1Department of General Surgery,Qilu Hospital of Shandong University, Jinan 250012, China; 2Department of Urology,Qilu Hospital of Shandong University; 3Department of Clinical Medicine,Medical College of Shihezi University; 4Department of Basic Medicine,Medical College of Shihezi University
Abstract：Objective： Prostate cancer is one of the cancer types in elder men. With the development of surgical robot technology, the robot-assisted laparoscopic radical prostatectomy (RARP) has gradually become the standard treatment, However, the postoperative use of suprapubic catheter (SPC) or urinary catheter (UC) is still controversial. The purpose of this paper is to provide updated evidence for comparison. Methods： Two individual researchers searched various datebases, including PubMed, Embase, Medline, Scopus, Ebscohost, CNKI and WanFang Data, with the time zone from each established time to December 2018. Then they compared the use of SPC and UC after RARP. The study took meta-analyses, all of which were performed by using the Review manager 5 (Cochrane Collaboration, China). Results： A total of 10 studies were included, including 3 groups of randomized controlled studies with evidence level 1b, 4 retrospective studies and 3 prospective non-randomized controlled studies, with a total of 1209 patients (623 in SPC group and 511 in UC group). There was no significant difference between the SPC group and the UC group in postoperative overall pain [POD1 (MD=0.18, P=0.78), POD3 (MD=0.29,P=0.46),POD6 (7)(MD=-0.31, P=0.08)]. However, SPC score of penile pain on POD6 (7) days, SPC score was lower than UC score (MD=-1.05, P<0.001).The overall postoperative complications were higher in the SPC group than in the UC group (RR=2.15, P=0.02), and there was no significant difference in urinary incontinence between the two groups at 6th and 12th weeks after surgery. There was no significant difference in the incidence of urinary retention (RR=1.16, P=0.67) or bladder spasm (RR=0.68, P=0.36) between the two groups, either. The incidence of postoperative urinary tract infection was higher in the UC group than in the SPC group, and the difference was statistically significant (RR=0.44, P=0.04). Conclusion： Compared with UC group, SPC group can reduce the discomfort of catheterization without increasing the probabilities of major complications. Therefore, SPC is a safe and effective choice for RARP surgery.
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