Comparison of Outcomes of the Routine Use of Pelvic Drain vs. No-Drain in Open Simple Retropubic Prostatectomy: A Randomised Controlled Clinical Study

Abstract Background: Drain use is an important aspect of the surgical management of patients. Although the use of pelvic drain in open simple retropubic prostatectomy (OSRP) has some advantages, its routine use is questionable considering the morbidities that may be associated with it. Objective: This study aimed to determine the usefulness of the drain in OSRP. Materials and Methods: This was a prospective, randomised controlled study in which eligible and consented patients scheduled for OSRP were randomised into two groups: group 1 (drain) or group 2 (no-drain). Both groups were evaluated for duration of surgery, postoperative pain, pelvic collection, surgical site infection (SSI), postoperative duration of hospital stay, and surgical incision scar outcome at the designated time based on the research protocol. Data analysis was done using SPSS, version 23. Results: A total of 50 patients were randomised into the study, 25 in each group. The duration of surgery was ≤120 min in 14 (56.0%) vs. 18 (72.0%) in groups 1 and 2, respectively ( P value of 0.239). Higher mean pain scores were found in group 1 compared with group 2 at 24, 72, and 120 h post-operation with P value of 0.036, 0.038, and 0.009, respectively. Most patients in group 2 had pelvic collection compared with group 1 on postoperative days (PODs) 3 and 7 (91.7% vs. 0%, P value = 0.001 f ) and (56.0% vs. 8.0%, P value = 0.001), respectively. The mean postoperative duration of hospital stay was higher in group 1 compared with group 2: 4.56 ± 0.87 vs. 3.28 ± 0.54 days, respectively ( P value = 0.001 f ). Conclusions: The evidence from this study suggests that routine pelvic drain use minimally reduces pelvic collection on PODs 3 and 7 but is associated with slightly higher postoperative pain scores at 24, 72, and 120 h and longer postoperative duration of hospital stay in patients undergoing OSRP. It does not affect the duration of surgery, the occurrence of SSIs, or the surgical incision scar assessment outcome.