Day care monopolar transurethral resection of prostate: Is it feasible?

Abstract

Introduction:Benign prostatic hyperplasia is a common disease accounting for 30% of our OPD cases and about 25% of our surgery cases. Various treatment options are now available for more efficient care and early return to work. We wanted to determine the safety and feasibility of day care monopolar transurethral resection of prostate (m-TURP), by admitting the patients on the day of surgery and discharging the patient without catheter on the same day. We also compared the morbidity associated with conventional TURP where in the catheter is removed after 24-48 h of surgery and day care TURP where in the catheter is removed on the day of surgery.Materials and Methods:A total of 120 patients who fulfilled the criteria were included in the study which was conducted between November 2008 and December 2010. A total of 60 patients were assigned for day care and 60 for conventional monopolar TURP. There was no significant difference in age, prostatic volume or IPSS score. Day care patients were admitted on day of surgery and discharged the same day after the removal of catheter.Results:Both the groups were comparable in outcome. Stricture rate was less with day care TURP. Mean catheterization time was similar to laser TURP.Conclusion:Monopolar TURP is still the gold standard of care for BPH. If cases are selected properly and surgery performed diligently it remains the option of choice for small and medium sized glands and patients can be back to routine work early.

Same Day Discharge is a Successful Approach for the Majority of Patients Undergoing Holmium Laser Enucleation of the Prostate

“…SDD further elevates the benefits of HoLEP over TURP, photoselective vaporization of the prostate (PVP), and OP. Although there are reports of SDD after TURP and PVP [21,22], these procedures typically require postoperative admission [7]. The ability to discharge patients at a high rate on the same day can truly revolutionize the treatment of BPH, especially for larger glands.…”

Catheter Removal on the Same Day of Holmium Laser Enucleation of the Prostate: Outcomes of a Pilot Study

“…There is limited literature regarding same day catheter removal with TURP and PVP, 14 , 15 and by removing the catheter the same day we can offer HoLEP with a single day encounter as well. Although patients required around two additional hours in the facility after post procedure discharge from the hospital, the practice of same day catheter removal saved patients many more potential hours of catheterization and a return trip to the clinic.…”

Day-case holmium laser enucleation of the prostate: feasibility, safety and predictive factors

“…At present, HoLEP and other laser operations only account for a small proportion of surgeries for bladder outlet obstruction in the UK. 2 TURP remains the primary operation for benign prostatic hyperplasia yet, despite a number of small case series showing that day-case TURP is feasible, 15,16 this procedure has yet to gain widespread adoption. It remains to be seen if these studies can be translated to the wider health service.…”