Self-removal of suprapubic catheter after retzius sparing robot-assisted radical prostatectomy: A feasibility audit

Introduction and objectives: We conducted a prospective audit to evaluate the feasibility of suprapubic catheter self-removal and what factors can interfere with the decision of self-removal, in post RS-RARP patients. Material and methods: Forty-four patients had a SPC inserted following a RS-RARP from January 2024 until May 2024, 36 of them opted for self-removal. Feedback was obtained 4 weeks post operatively regarding catheter related symptoms and the complexity of self-removal procedure. Results: Most patients reported minimal overall pain (median = 2), with penile pain most frequently rated as none (mode = 1). Bladder cramps and overall problem perception were also low (median = 1); 65.9% of patients reported no bladder cramps, and 61.4% had no issues with SPC management. Factors such as overall pain ( p = 0.234), penile pain ( p = 0.286), and overall problem perception ( p = 0.643) did not significantly influence the decision of SPC self-removal. However, bladder cramp frequency had impacted the self-removal decision ( p = 0.029). The majority (80.6%) found self-removal easy, with only 11.1% considering it complicated. Most patients also recommended self-removal, reinforcing its overall feasibility. The perceived complexity of self-removal was associated with likelihood to recommend the procedure ( p < 0.001). Additionally, penile pain correlated with bladder cramps ( p = 0.006) and overall problem perception ( p = 0.003), suggesting discomfort in one area may reflect a broader negative experience affecting patients’ decision making regarding self-removal, as patients with higher bladder cramps were less likely to recommend self-removal ( p = 0.008). Conclusion: SPC self-removal after RS-RARP appeared feasible and acceptable in a selected group of patients supported by structured education and specialist nurse follow-up. These findings should be interpreted cautiously given the small single-center sample, absence of randomization, and use of a non-validated questionnaire. Further comparative studies are required before wider implementation can be recommended.