Length of postoperative hospital stay after transurethral resection of the prostate

The aim of the study is to explore the value of audit in investigating and reducing the length of stay (LOS) of patients after transurethral resection of the prostate (TURP). All TURPs in a district general hospital (DGH) were audited over 30 weeks. Particular attention was paid to patients whose LOS was longer than the average for the group (mean: 6.4 nights; median: 5 nights). Older age of the patient, larger resections and late removal of suprapubic catheters were statistically significant in prolonging LOS (P < 0.001). General anaesthesia was associated with longer stay than regional anaesthesia, but the difference was not statistically significant. Among patients whose LOS exceeded the average of 6 nights, social circumstances and detrusor underactivity were the most important causes of late discharge, accounting for 44% (28/63) of these cases. Where factors were avoidable, changes were implemented. Increased use of regional anaesthesia was encouraged. Catheters were removed earlier, and discharges, whenever possible, were pre-planned. A re-audit was carried out 1 year after the original audit and a significant decrease in LOS was found (mean: 5.2 nights; median: 4 nights; P < 0.01). Audit can increase awareness of prolonged hospital stay and highlight areas for change. Re-audit can confirm the effectiveness of these changes.