Day case TURP in a stand-alone unit with no beds - is this feasible? Prospective review of the first 100 cases
BAUS ePoster online library. Blach O. Jun 27, 2018; 211366
Ms. Ola Blach
Ms. Ola Blach
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Abstract
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Introduction: Inpatient TURP remains the gold standard operation for BPH but advances in novel procedures increasingly allow for same day discharges. We have reviewed our new day-case TURis service in a stand-alone unit with no inpatient capacity.

Patients and Methods: 100 consecutive patients under the care of a single consultant were prospectively reviewed. Standard Trust policy for day-case surgery and <80cc prostates were intended selection criteria. Larger prostates were partially resected (middle and 1 lateral lobe). Outpatient TWOCs were performed following surgery.

Results: 53 patients underwent TURis for LUTS, 46 for retention (41 with pre-op catheter) and 2 for haematuria. Of the 63 patients who had measured prostate volumes, 17 had >80cc.
Average resection time was 38min (range 5-90min), with resected volume of 17.2g (range 1-40g). Button diathermy/ablation electrode was used in addition to the loop in 11 cases.
Only 1 patient (1%) required post-op ambulance transfer to the main hospital due to haematuria, and was discharged after overnight observation.
Within the first 30 days 4 patients were readmitted: 1 with urosepsis, 1 with acute retention post-TWOC, and 2 with haematuria, of which 1 required RBC transfusion following secondary haemorrhage (1%). 18 patients attended A&E during that time: 17 with catheter-related issues and 1 with LUTS post-TWOC.
Average time to post-TURis TWOC was 5.8 days. 96 patients passed first TWOC, with 99 catheter-free at 30 days.

Conclusions: Day-case TURIS can be delivered safely and effectively in a stand-alone unit with very low rates of admission.
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