Examination of necessity for pelvic drain placement after robot-assisted radical prostatectomy

PurposeRadical prostatectomy is the gold standard treatment for clinically localised prostate cancer. Pelvic drain (PD) placement is commonly performed after RARP to prevent the formation of urinary cysts, pelvic hematomas and lymphoceles that would require further treatment. RARP has been reported to have few perioperative complications, and the need for PD placement is not clear. This study aimed to assess the need for PD placement after robot-assisted radical prostatectomy (RARP). MethodThis retrospective uncontrolled before-after study analysed the effect of PD placement on postoperative complications in patients who underwent RARP between May 2009 and April 2018.ResultsAll patients prior to October 1, 2016 had a PD placed; those after did not. Of the 308 study patients, 231 received a PD (PD group) and 77 did not (ND group). The incidence of ileus, urinary tract infection and anastomotic leak did not differ significantly between the groups; nor did the incidence of asymptomatic and symptomatic lymphocele at 2 weeks and 1 year after surgery. Multivariate analysis showed that lymph node dissection is a predictor of asymptomatic lymphocele development two weeks after surgery.ConclusionPD placement is not necessary after RARP. Future large-scale studies are required to identify patients that would benefit from PD placement.