RESUMO
OBJECTIVE: To assess the feasibility, safety, and predictive factors for the success of holmium laser enucleation of the prostate (HoLEP) with catheter removal and hospital discharge on the same day of the procedure. METHODS: This prospective study included 34 patients who underwent HoLEP using a 60-W holmium laser device and the Wolf Piranha morcellation system. Surgeries began at 10:30 am and the patients were expected to be discharged by 5 pm on the same day. The patients underwent a voiding trial to remove the urinary catheter before hospital discharge. Functional outcomes were assessed 90 days after the procedure. RESULTS: Mean (range) age, prostate-specific antigen value, and prostate weight were as follows: 63.4 (50-80) years, 4.81 (0.19-14) ng/mL, and 89.3 (33-258) g, respectively. The mean (range) enucleation and morcellation times were 56.2 (29-91) minutes and 14.67 (3-45) minutes, respectively. Thirty-one patients (91.1%) were discharged on the same day of the procedure after urinary catheter removal. CONCLUSION: The performance of HoLEP is safe on an outpatient basis. Same-day catheter removal is feasible and does not affect hospital discharge.
RESUMO
In recent years, the development of new imaging techniques and scoring systems have improved the diagnosis and management of small renal masses. Imaging-based nephrometry scoring systems play an interesting role in the planning of nephron-sparing surgery, providing surgeons with the information necessary to determine the complexity of the renal mass, to deliver the appropriate postoperative care, and to predict adverse outcomes. The aim of this study was to review nephrometry scoring systems, evaluating their characteristics and the relationships among them. The urology and radiology communities should decide which nephrometry scoring system will prevail and be used in daily practice.
O diagnóstico e o manejo das pequenas massas renais têm sido aprimorados nos últimos anos com o desenvolvimento de técnicas de imagem e escores que desempenham papel interessante no planejamento da nefrectomia parcial, fornecendo informações importantes ao cirurgião para determinar o tipo de tratamento em relação a complexidade da massa renal, cuidados pós-operatórios e previsão de complicações após as cirurgias. O objetivo deste estudo é revisar os escores de nefrometria, suas características e relações entre eles no cenário da cirurgia. Os serviços de urologia e radiologia devem decidir qual é o melhor escore de nefrometria para ser utilizado na prática diária.
RESUMO
Abstract In recent years, the development of new imaging techniques and scoring systems have improved the diagnosis and management of small renal masses. Imaging-based nephrometry scoring systems play an interesting role in the planning of nephron-sparing surgery, providing surgeons with the information necessary to determine the complexity of the renal mass, to deliver the appropriate postoperative care, and to predict adverse outcomes. The aim of this study was to review nephrometry scoring systems, evaluating their characteristics and the relationships among them. The urology and radiology communities should decide which nephrometry scoring system will prevail and be used in daily practice.
Resumo O diagnóstico e o manejo das pequenas massas renais têm sido aprimorados nos últimos anos com o desenvolvimento de técnicas de imagem e escores que desempenham papel interessante no planejamento da nefrectomia parcial, fornecendo informações importantes ao cirurgião para determinar o tipo de tratamento em relação a complexidade da massa renal, cuidados pós-operatórios e previsão de complicações após as cirurgias. O objetivo deste estudo é revisar os escores de nefrometria, suas características e relações entre eles no cenário da cirurgia. Os serviços de urologia e radiologia devem decidir qual é o melhor escore de nefrometria para ser utilizado na prática diária.
