CURRENT ERA HOLMIUM LASER ENUCLEATION OF THE PROSTATE IS A SAFE, RELIABLE DAY SURGERY

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology II (MP32)1 Apr 2020MP32-11 CURRENT ERA HOLMIUM LASER ENUCLEATION OF THE PROSTATE IS A SAFE, RELIABLE DAY SURGERY Deepak K Agarwal*, Marcelino E Rivera, Christa L Stoughton, Chanel A Stephens, Tim Large, and Amy E Krambeck Deepak K Agarwal*Deepak K Agarwal* More articles by this author , Marcelino E RiveraMarcelino E Rivera More articles by this author , Christa L StoughtonChrista L Stoughton More articles by this author , Chanel A StephensChanel A Stephens More articles by this author , Tim LargeTim Large More articles by this author , and Amy E KrambeckAmy E Krambeck More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000876.011AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Holmium laser enucleation of the prostate (HoLEP) has traditionally required an overnight stay for continuous bladder irrigation. With the introduction of new laser technology we transitioned our HoLEP practice to same day discharge. The goal of this study was to review our outpatient HoLEP experience and compare outcomes to our inpatient cohort. METHODS: We performed a single center retrospective review of HoLEPs from July 2018 to October 2019 by three surgeons. In March 2019, we transitioned our practice to same day discharge HoLEP (sddHoLEP) regardless of prostate size or anticoagulation status, with exception for significant medical comorbidites. We compared preoperative, operative and postoperative data between overnight admit HoLEPs (oaHoLEP) versus sddHoLEP. Catheters were removed on postoperative day 1 for all patients. Statistical analysis between the groups are presented. RESULTS: Results: There were 244 oaHoLEP patients and 84 sddHoLEP patients over the study period. Mean age of the entire cohort was 71.1 ± 8.9 years, mean BMI 28.3 ± 5.1, and mean prostate volume 104.2 ± 69.44 ml. There was a non-clinically significant difference between age (oaHoLEP 71.7 vs sddHoLEP 69.6, p=0.042). There were no other differences in demographic data, including number of glands >200 ml in either group (oaHoLEP 7.8% vs sddHoLEP 8.3%, p=0.48). Operative and postoperative data can be found on Table 1. There was only one patient in the sddHoLEP group who was converted to oaHoLEP due to need for continued CBI for postoperative hematuria. Successful voiding on postoperative day 1 after catheter removal was significantly higher in the sddHoLEP group compared to the oaHoLEP patients. There was a significantly higher use of the laryngeal mask airway and MOSES laser system in sddHoLEP, and also a slightly faster enucleation time. At 3 month follow-up for those with available data, there were comparable outcomes and rates of complications in each group. CONCLUSIONS: Outpatient HoLEP is safe, feasible, and without significant risk for complications requiring admission regardless of prostate size or anticoagulation status. Furthermore, there may be benefits to same day discharge by decreasing time to first successful void. More study is needed to elucidate who should require admission. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e488-e489 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Deepak K Agarwal* More articles by this author Marcelino E Rivera More articles by this author Christa L Stoughton More articles by this author Chanel A Stephens More articles by this author Tim Large More articles by this author Amy E Krambeck More articles by this author Expand All Advertisement PDF downloadLoading ...