Day case TURP - is it possible?

ABSTRACT

OBJECTIVE: To determine if day case transurethral resection prostatectomy (TURP) was possible, safe and gave excellent results. DESIGN AND METHODS: A prospective study was undertaken on 75 consecutive patients over an 18-month period. Patients' mean age was 65 years (range 51-76 years) and all had significant obstruction with an average American Urology Association (UA) score of 21 (range 14-28). They were admitted in the morning and a conventional TURP was performed before noon under spinal anaesthesia. Meticulous attention was paid to haemostasis. Intravenous frusemide was used both intra- and post-operatively and rapid irrigation with 0.9 percent saline was given post operatively. The patient was ambulated and discharged on the day of surgery. Follow-up was done by phone for the first 48 hours. RESULTS: The average operating time was 55 minutes (range 35-65 minutes) and 85.3 percent (67) were discharged on the day of surgery. The average duration of stay was 7.1 hours (range 6.5-9.2 hours), 6 were discharged <24 hours and 2 >24 hours. The mean prostatic weight was 30 g (range 12-45g). No transfusions were necessary, urinary tract infection occurred in 4 percent (3) post operative fever in 2.6 percent (2), chest pains in 1.4 percent (1) and re-catheterisation in 1.4 percent (1). There were no cases of clot retention or re-admission. Patient satisfaction was high (96 percent). CONCLUSIONS: Day-case TURP is possible and it is a safe, cost effective alternative to the standard TURP procedure.(Au)