# Impact of Prolonged Catheterization for Vesicourethral Leakage on Continence and Quality of Life After Robotic Prostatectomy

## TL;DR

This study finds that extended catheter use due to leakage after prostate surgery does not harm long-term urinary control or quality of life.

## Contribution

The study is the first to show that prolonged catheterization after prostate surgery does not negatively impact continence or quality of life.

## Key findings

- Continence recovery was similar between prolonged and standard catheter groups at 1, 6, and 12 months.
- Quality of life outcomes were comparable despite prolonged catheterization.
- Prostate specimen weight and intraoperative leakage predicted prolonged catheterization.

## Abstract

Introduction: To determine whether prolonged urinary catheterization due to vesicourethral anastomotic leakage (VAL) after robot-assisted radical prostatectomy (RARP) impacts urinary continence recovery and quality of life (QOL).

Methods: We retrospectively analyzed 360 patients who underwent transperitoneal RARP at a single institution from January 2022 to December 2024. All patients underwent cystography on postoperative day 6 or 7. Those with VAL requiring extended catheterization were compared with patients undergoing standard removal. Continence was assessed using Question 5 of the Expanded Prostate Cancer Index Composite (EPIC), and QOL was measured with the Functional Assessment of Cancer Therapy-General (FACT-G), FACT-Prostate (FACT-P), and the EPIC urinary subscale. Outcomes were evaluated up to 24 months postoperatively.

Results: VAL was detected in 36 patients (10.0%). Continence recovery did not differ significantly between the prolonged and standard catheter groups at 1, 6, or 12 months (63%, 89%, 92% vs. 54%, 85%, 93%, respectively). QOL outcomes were also comparable, although preoperative EPIC scores were lower in the prolonged catheter group. Multivariate analysis identified greater prostate specimen weight (p = 0.049) and intraoperative leakage (p = 0.002) as independent predictors of prolonged catheterization.

Conclusions: Prolonged urinary catheterization due to VAL after RARP does not adversely affect long-term urinary continence recovery or urinary-related QOL.