Robotic Surgery & Catheters

I'd like to know from the guys who had robotic surgery how long they had to have the catheter in.  My husband will be having surgery this Monday and then will return to have the catheter taken out on Friday.  Is that too soon to have it taken out?  I know they do a test to see if it's okay to remove, but should we insist that he have it in at least a week? 

Four days sounds real short to me... If it comes out early you end up in the ER Friday night to get a cath put back in.

The following is the $750 to $1000 test you asked about. I had 3 or 4 of them and my cath ended up being in for five weeks.

Cystogram
A cystogram is an x-ray examination of the urinary bladder, which is located in the lower pelvic area. A cystogram can show the bladder's position and shape, and the exam often is used to diagnose a condition called reflux. Reflux occurs when urine in the bladder moves back up the ureters, the tubes that transport urine from the kidneys to the bladder. This condition can cause repeated urinary tract infections. A cystogram may be performed after a patient has experienced a pelvic injury to ensure that the bladder has not torn. Cystograms also are used to detect polyps or tumors in the bladder.
https://www.asrt.org/content/ThePublic/aboutRadiologicProcedures/Cystogram.aspx

I had robotic surgery on June 9th and had the catheter removed 8 days later on June 17th. Four days does not sound near long enough to allow proper healing of the urethra.

I'm not a doctor, but because I've had an interest in how the treatments (surgery especially) have historically evolved over time, I've read and learned a bit about this.

To first add some perspective, the catheter time used to typically be longer, but with the majority of patients reporting the catheter as their greatest source of postoperative complaints, doctors have been moving carefully to shorter times. Ten years ago, the typical duration was 2-weeks, but a study was performed (all after open RP) looking at postoperative day (POD) 7. The conclusion was that if cystograms verified watertightness, it was good to go...in fact, their conclusion was that early removal was both "feasible and desirable."

Surgical techniques have further improved since then, and more recently a similar study was performed on patients who specifically had the "eight-suture vesicourethral anastomosis" sub-procedure. In this study, removal was at an average of POD 3.2 (most were 3 days after surgery). Results were the same...the cystogram was negative (it held water) in most cases, and if the test was negative the cathater was fine to pull.

I had mine in for 1-week after surgery, but my doctor didn't bother with a cystogram. Your husband's doctor seems to be trying to do him a favor by pulling it early, if his cystogram is negative.

hope this helps...

I am a doctor, but that is irrelevant here. I am a patient two years out from the robot. I trusted my doctor and had my catheter out in 4 days. A cystogram was done before removal at about ten AM, and I watched it on fleuroscopy. I then spent a few hours on the ward, drinking water and testing my continence. about seven PM, I went home, and that was that. The anastomotic techniques have improved over several years. Epithelium of the body's viscera heals rapidly. A positive cystogram showing extravasation of the contrast would have meant another week with the catheter. I believe the rapid removal may help prevent scarring in the urethral canal.

I delt with the cath for 10 days.

My surgery (RALP) was on 20 July and the catheter came out on 27 July after a cystogram.

Pretty sure your surgeon knows what he/she is doing on that, certainly no set rule. I had open surgery, and due to surgical complications, my original catheter was left for 30 days, and then it got extended to 63 days.

Good luck to you.

David in SC