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Is day‐case prostatectomy feasible?
Author(s) -
KEOGHANE S.R.,
MILLAR J.M.,
CRANSTON D.W.
Publication year - 1995
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1995.tb07785.x
Subject(s) - medicine , prostatectomy , blood loss , surgery , catheter , indwelling catheter , urology , urinary retention , general anaesthesia , anesthesia , prostate , cancer
Objective To assess the possibility of discharging patients, catheter‐free, on the same day that they undergo contact‐laser prostatectomy. Patients and methods Ten patients underwent contact vaporization of the prostate using the SLT (Surgical Laser Technologies, Oaks, PA, USA) Nd:YAG laser with an MTRL10 6 mm tip. Patients were selected in the out‐patient clinic for day‐case surgery on the basis of their good general health and clinically small glands. All patients had pre‐operative urodynamic assessment and were proven obstructed and stable. Contact vaporization was carried out under general anaesthesia. Both intra‐operative blood loss and irrigant absorption were assessed. The follow‐up at 3 and 6 months included American Urological Association (AUA‐7) symptom scores and the measurement of urinary flow rates. Results The mean operating time was 25.2 min, with a mean application of 43.05 kJ of laser energy. The mean absorption of irrigant fluid was 30 mL and the mean intra‐operative blood loss was 31 mL. Nine patients were discharged on the day of treatment. Two patients went into clot retention following discharge and had a suprapubic catheter sited, and two failed to void once discharged, necessitating catheterization for 2 weeks. At 3 and 6 months, there was a substantial decrease in the AUA symptom score and an improvement in urinary flow rate. Conclusion Day‐case laser prostatectomy is possible, but the patients must be selected carefully and, perhaps more importantly, a specialist day‐case anaesthetist must be available.