Early catheter removal after transurethral resection of the prostate

Post-operative care of transurethral resection of the prostate (TURP) includes prolonged bladder irrigation that places a heavy burden on the nursing staff and a substantial strain on the budget. There is a trend towards early catheter removal after TURP even to the extent of performing it as a day case. We explored the feasibility and limitations of early catheter removal after TURP in our unit.

Prospective study.

Department of Urology, The National Hospital of Sri Lanka (NHSL), Colombo.

The study was in a tertiary referral centre (NHSL), on 65 patients with a mean age of 67.5 years who underwent TURP for mild to moderate enlargement of the prostate, less than 25 g, with lower urinary tract symptoms. Post-operative irrigation was maintained by diuretics at operation or a short term saline irrigation in the operating theatre.

17 patients developed clot retention in the ward that was managed by irrigation for 12 to 24 h. 62 patients who had clear or minimally blood-stained urine were tried without catheter after 24 h. Only two failed to pass urine. Patients without other complications were discharged from hospital after 1 or 2 successful voidings on the same day. There were no readmissions with complications.

This study supports the feasibility of early catheter removal after a short irrigation period in TURP in the majority of patients with mild to moderate enlargement of the prostate without significantly increasing post-operative complications.