Outcomes of Same Day Discharge Following Holmium Laser Enucleation of the Prostate

ABSTRACT

Introduction &Objective: Performing holmium laser enucleation of the prostate (HoLEP) as a same day surgery is a safe and feasible option for the majority of patients. Shortening postoperative hospital stays can minimize patient burden and increase accessibility to surgical care. We present our experience of 155 patients who underwent HoLEP during the pandemic last year. Admissions were limited to patients that required continuous bladder irrigation given the limited surgical bed availability and other restrictions imposed by the Covid-19 pandemic. Method(s) From January 2021 till January 2022, 155 patients have undergone HoLEP surgery in which 135 were discharged on the same day and 20 patients were admitted. Perioperative data were retrospectively collected, and postoperative outcomes at least 2 months after the surgery were evaluated in terms of safety and efficacy and compared in both groups using chi-square and t-test. Multivariable logistic regression was also performed to identify factors associated with postoperative complications. Result(s) The mean age of the same day discharge group (n = 135) is 71.2 (SD = 7.1). The mean prostate specific antigen(ng/dL) and prostate volume(mL) in the same-day discharge group were 5.3 (range 0.16-48.4) and 112.6 (range 52-350), respectively, with 3.7% readmission rate and 9.6% emergency department visit rate. Our same-day discharge rate was 87% of the total patients. Prostate Specific Antigen (P =.001), prostate volume (P <.001), and enucleated tissue weight (P =.04) were significantly higher in the admitted group. There was no difference in the rate of postoperative emergency department visits (P =.80), readmissions (P = 1), postoperative complications, and catheterization time (P =.98) between both groups. Patients using blood thinners had 3.35 (95% CI 1.24-9.08) greater odds of having postoperative complications. Conclusion(s) Same-day discharge following HoLEP is a safe and effective approach in most patients without an increase in postoperative complications.