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

  • Haidar Abdul-MuhsinEmail author
  • William Critchlow
  • Anojan Navaratnam
  • James Gnecco
  • Kimberly Tay
  • Marlene Girardo
  • Paul Andrews
  • Scott Cheney
  • Mitchell Humphreys
Original Article
  • 3 Downloads

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.

Keywords

Holmium HoLEP Prostate Same day surgery BPH 

Notes

Author contributions

H A-M: project development, data collection and management, data analysis and manuscript writing. WC: protocol and project development, data collection and manuscript editing. AN: manuscript editing. JG: data collection and project development. KT: data collection and project development. MG: statistical analysis. PA: manuscript editing. SC: manuscript editing. MH: project and protocol design, manuscript editing.

Funding

None.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of UrologyMayo Clinic in ArizonaPhoenixUSA
  2. 2.Division of Biostatistics, Department of Health Sciences ResearchMayo Clinic in ArizonaScottsdaleUSA

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