In a population based cohort, two-thirds of men diagnosed with prostate cancer qualify for active surveillance. Less restricted criteria for surveillance may be appropriate based on similar rates of upgrading/up staging at radical prostatectomy.

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The current AUA guidelines for asymptomatic microhematuria (AMH) recommends in patients with negative initial workup, annual urinalyses (UAs) should be obtained and repeat workup performed within 3-5 years in those with recurrent or persistent AMH. There is little data on the yield of repeat evaluation. Our hypothesis was that repeat AMH workup yields a low detection rate of urologic (GU) malignancy.METHODS: We retrospectively reviewed all patients at our institution who underwent an AMH workup with cystoscopy and upper tract imaging from

of the various procedures performed at the PSU was compared to the cost incurred when performed in the operating room.RESULTS: Sixty-one patients aged 6 months to 17 years underwent minor urologic procedures [meatotomy/meatoplasty (22), lysis of penile adhesions and skin bridges (33), other minor procedure (6)] during this time period. Ten procedures were performed under sedation that ranged from minimal to moderate sedation and analgesia (16%), the remaining 51 procedures were managed with deep sedation and analgesia (84%). Median procedure duration was 8 minutes. No patient needed general anesthesia. Thirty parents (49%) completed the followup survey with mean overall satisfaction scores of 4.7 on an ordinal scale from 1 to 5. 83% of parents "strongly agreed" that they were satisfied with the care their family received, and 86% would "strongly recommend" the PSU for procedures like these. When comparing the cost between the PSU and the operating room, we found that there was at least 36% cost reduction, and varied by procedure performed.CONCLUSIONS: Driven to be more cost effective and efficient, sedation for pediatric urology procedures outside the operating room is a sustainable option. Furthermore, the PSU provides a safe and satisfactory patient experience for outpatient procedures in pediatric urology.