Feasibility of holmium laser enucleation of the prostate as a 1-day surgery

Haidar Abdul-Muhsin, William Critchlow, Anojan Navaratnam, James Gnecco, Kimberly Tay, Marlene Girardo, Paul Andrews, Scott Cheney, Mitchell R Humphreys

Research output: Contribution to journalArticle

Abstract

Purpose: To assess the safety and feasibility of HoLEP as a day-case procedure. Methods: We reviewed all consecutive patients who underwent HoLEP at our institution between February 2017 and March 2018. During this time, we began a prospective trial aimed at same-day discharge of specific patients. Baseline and demographic variables, and past medical, past urological, intra-operative and post-operative variables in addition to disposition and readmission data were collected. Bivariate analysis was conducted to compare patients based on the day of discharge and readmission. A multivariable model using multiple-regression analysis was used to assess predictors for early discharge or readmission. Results: There were 179 total HoLEP procedures that were performed during the study period. Forty-seven patients were suitable candidates for same-day discharge. Among this group, 28 (59.5%) patients were successfully discharged home on the same day. Nineteen patients (40.4%) could not be discharged. The most common cause of not to discharge patients was the degree of hematuria without continuous bladder irrigation. Pre-operative prostate volume was different between the two groups (88.4 ± 30.7 cc for discharged patients vs 69.0 ± 30.7 cc for admitted patients, p = 0.033). No other pre-operative differences were identified. There were five readmissions (17.8%) following same-day discharge. Readmitted patients had higher rates of history of urinary tract infection (80% vs 26.2%, p = 0.0304). On multivariable analysis, no statistically significant predictors were identified for early discharge or readmission. Conclusions: Same-day discharge following HoLEP is safe and feasible in well-selected patients.

Original languageEnglish (US)
JournalWorld Journal of Urology
DOIs
StatePublished - Jan 1 2019

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Solid-State Lasers
Ambulatory Surgical Procedures
Prostate
Patient Discharge
Hematuria
Urinary Tract Infections
Urinary Bladder
Regression Analysis
Demography
Safety

Keywords

  • BPH
  • HoLEP
  • Holmium
  • Prostate
  • Same day surgery

ASJC Scopus subject areas

  • Urology

Cite this

Feasibility of holmium laser enucleation of the prostate as a 1-day surgery. / Abdul-Muhsin, Haidar; Critchlow, William; Navaratnam, Anojan; Gnecco, James; Tay, Kimberly; Girardo, Marlene; Andrews, Paul; Cheney, Scott; Humphreys, Mitchell R.

In: World Journal of Urology, 01.01.2019.

Research output: Contribution to journalArticle

Abdul-Muhsin, H, Critchlow, W, Navaratnam, A, Gnecco, J, Tay, K, Girardo, M, Andrews, P, Cheney, S & Humphreys, MR 2019, 'Feasibility of holmium laser enucleation of the prostate as a 1-day surgery', World Journal of Urology. https://doi.org/10.1007/s00345-019-02831-6
Abdul-Muhsin, Haidar ; Critchlow, William ; Navaratnam, Anojan ; Gnecco, James ; Tay, Kimberly ; Girardo, Marlene ; Andrews, Paul ; Cheney, Scott ; Humphreys, Mitchell R. / Feasibility of holmium laser enucleation of the prostate as a 1-day surgery. In: World Journal of Urology. 2019.
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AU - Tay, Kimberly

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AU - Cheney, Scott

AU - Humphreys, Mitchell R

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AB - Purpose: To assess the safety and feasibility of HoLEP as a day-case procedure. Methods: We reviewed all consecutive patients who underwent HoLEP at our institution between February 2017 and March 2018. During this time, we began a prospective trial aimed at same-day discharge of specific patients. Baseline and demographic variables, and past medical, past urological, intra-operative and post-operative variables in addition to disposition and readmission data were collected. Bivariate analysis was conducted to compare patients based on the day of discharge and readmission. A multivariable model using multiple-regression analysis was used to assess predictors for early discharge or readmission. Results: There were 179 total HoLEP procedures that were performed during the study period. Forty-seven patients were suitable candidates for same-day discharge. Among this group, 28 (59.5%) patients were successfully discharged home on the same day. Nineteen patients (40.4%) could not be discharged. The most common cause of not to discharge patients was the degree of hematuria without continuous bladder irrigation. Pre-operative prostate volume was different between the two groups (88.4 ± 30.7 cc for discharged patients vs 69.0 ± 30.7 cc for admitted patients, p = 0.033). No other pre-operative differences were identified. There were five readmissions (17.8%) following same-day discharge. Readmitted patients had higher rates of history of urinary tract infection (80% vs 26.2%, p = 0.0304). On multivariable analysis, no statistically significant predictors were identified for early discharge or readmission. Conclusions: Same-day discharge following HoLEP is safe and feasible in well-selected patients.

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