Age is but a number: greenlight laser prostatectomy is a safe day surgery operation for men of 75 years and over
BAUS ePoster online library. Rintoul-hoad S. Jun 27, 2018; 211367; P8-6 Disclosure(s): Mr G Muir is a senior lecturer for PVP technique (Boston scientific)
Ms. Sophie Rintoul-hoad
Ms. Sophie Rintoul-hoad
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Abstract
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The incentive to provide daycase urology, such as Greenlight XPS™laser Prostatectomy (PVP) is growing; yet a growing elderly population leads to questions of safety and efficacy.

Method: Retrospective analysis of 254 patients undergoing 180W PVP in a single Day Surgery Unit: 2015-17.

Results: 31% patients (78/254) were 75 or over (75-92). 42% (n=33) of over 75s were pre-catheterised; under: 15% (n=27). 66% of over 75s had >60cc prostate compared to 47% of under 75s. 27% (n=21) of over 75s had ≥2 co-morbidities; under: 13% (n=22). 41% (n=32) of over 75s took anti-coagulation/ anti-platelets; under: 18% (n= 31).
72% (n=56) of over 75s had daycase PVP; under: 85% (n=149). Unplanned admission was similar in both groups (4% vs 3%). Only one patient returned to theatre (85 year old on anti-coagulation). No patients required blood transfusion. There were no deaths. 8 patients overall required some electrosurgical resection due to bleeding or technical problems; 6 were over 75. 12% (n=9) of over 75s were catheter-free 'day zero'; under: 13% (n=22); both groups had similar catheter-free rate by day 5 (80%). Catheter-free status at 3 months was 99%. 14% (n=11) of over 75s re-attended hospital post-discharge from DSU; under: 11% (n=19). 3 older patients required re-admission for infection (1), symptoms (1), AUR (1); under: n=5. 3 months follow-up: mean QOL and IPSS score was the same. 65% of over 75s PVR<100ml (under: 86%) and 69% had a Qmax >12mls/s (under:89%).

Conclusion: The majority of men over 75 can have daycase laser prostatectomy with excellent safety and efficacy.
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