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Is day-case prostatectomy feasible?

S R Keoghane¹, J M Millar, D W Cranston

¹Department of Urology, Churchill Hospital, Oxford, UK.

British Journal of Urology

|November 1, 1995

Summary

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Same-day discharge after contact laser prostatectomy is feasible for carefully selected patients. This approach requires careful patient selection and the availability of a specialist day-case anaesthetist for successful outcomes.

Area of Science:

Urology
Minimally Invasive Surgery
Laser Therapeutics

Background:

Benign prostatic hyperplasia (BPH) is a common condition requiring surgical intervention.
Traditional prostatectomy often involves significant recovery time and hospital stays.
Contact laser prostatectomy offers a potentially less invasive surgical option.

Purpose of the Study:

To evaluate the feasibility of same-day discharge for patients undergoing contact laser prostatectomy.
To assess the safety and efficacy of day-case laser prostatectomy.

Main Methods:

Ten patients with clinically small prostates and proven obstruction underwent contact vaporization using the Nd:YAG laser.
Patients were selected for day-case surgery based on good general health.

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Outcomes were assessed via pre-operative urodynamics, intra-operative blood loss, irrigant absorption, and post-operative symptom scores (AUA-7) and urinary flow rates at 3 and 6 months.

Main Results:

Nine out of ten patients were discharged on the same day of the procedure.
Mean operating time was 25.2 minutes with a mean energy application of 43.05 kJ.
Minor complications included clot retention (2 patients) and temporary voiding difficulties (2 patients), requiring catheterization for 2 weeks. Significant improvements in AUA symptom scores and urinary flow rates were observed at 6 months.

Conclusions:

Day-case contact laser prostatectomy is a viable option for select patients.
Careful patient selection and the availability of a specialist day-case anaesthetist are crucial for successful implementation.
This approach can potentially reduce healthcare costs and improve patient convenience.