Discharge in less than 30 hours after an open radical retropubic prostatectomy. A prospective study

Abstract

e16156 Background: Radical Retropubic Prostatectomy (RRP) is one of the most frequent surgery performed by urologists and it has been accompanied by an improvement in surgical results such as duration of hospitalization. In this study we prospectively analyzed the viability of an early discharge from hospital after an open RRP. Methods: There were 37 consecutive RRP performed by the same surgeon from March 1st to August 30th of 2007. All of the patients were informed about the possibility of discharge from hospital in less than 30 hours after the surgery. The procedures were performed using a modified Walsh technique under combined anesthesia (general anesthesia and epidural anesthesia p analgesia with morphine) through midline incision initiated approximately 5,0 centimeters below of umbilicus. Obturatory lymphadenectomy was performed in only three patients and Exclusion criteria included patients with an Body Mass Index above 30, patients who refused to participate in the study and those with prior indication to go to the intensive care unit postoperatively. Respiratory and motor physiotherapy were initiated soon after return from the surgical block. Criteria to discharge from hospital included: good acceptance of oral diet, no need for parenteral analgesics; urinary volume > 75 ml/hour; no Foley catheter obstruction; absence of gross hematuria; urine drainage < 150 ml/24 hours. Results: 32 patients (86%) had discharged from hospital in less than 30 hours after the surgery: there were 25 patients (68%) discharged in the first 24 hours after surgery and 07 patients discharged between 24 and 30 hours after surgery. There wasn't any readmission in a period of 15 days after discharge from hospital. There were only three complications (8%)on days 07, 10 and 13 and 01 patient need to wash an obstructed Foley catheter with blood clot at postoperative day four. Conclusions: By means of simple criteria it is possible to early discharge patients after an open RRP in selected patients and it may represent a significant reduction in costs. No significant financial relationships to disclose.