Background: Monopolar
transurethral resection of prostate has long been a standard method of
managements of benign prostatic hyperplasia. The safe and superior efficacy of
transurethral resection of prostate (TURP) always argues strongly for
maintaining it as the primary mode of therapy for patients with benign
prostatic hyperplasia (BPH). There is a trend toward early catheter removal
after transurethral resection of prostate (TURP) even to the extent of
performing it as a day case. We explored the safety and feasibility of early
catheter removal and discharging the patient without catheter after TURP.
Materials and methods: Forty patients who underwent monopolar TURP were
included in a prospective study. The decision to remove catheters on the first
morning after surgery was based on the color of the catheter effluent, absence
of clots, normal vital signs and adequate urine output. Patients who voided successfully
were discharged on the same day as catheter removal. Results: Among the forty
patients whose catheters were removed on first postoperative day, 38 patients
(95%) voided successfully, and were discharged on the same day. However, two
out of forty patients (5%) were recatheterized due to urethral discomfort
during micturition. The catheter was removed on the next day. Mean overall
duration of catheterization was 18.36 hours, and overall length of patient
hospitalization was 21.68 hours. Conclusions: Overnight hospitalization and
early catheter removal after transurethral prostatectomy are an appropriate,
safe and effective way of patient care with minimal morbidity.
References
[1]
Presti Jr., J.C., Kane, C.J., Shinohara, K. and Carroll, P.R. (2008) Neoplasms of the Prostate Glands Smith’s General Urology. 17th Edition, McGraw Hill Medical, New York, 348-374
[2]
Kirby, R.S. and McConnell, J. (2005) Benign Prostatic Hyperplasia. 5th Edition, Health Press (NM), London, UK.
[3]
Gordon, N.S.I., Hadlow, G., Knight, E. and Mohan, P. (1997) Transurethral Prostatectomy: Still the Gold Standard. Australian and New Zealand Journal of Surgery, 67, 354-357. http://dx.doi.org/10.1111/j.1445-2197.1997.tb01991.x
[4]
Flanigan, R.C., Reda, D.J., Wasson, J.H., Anderson, R.J., Abdellatif, M. and Bruskewitz, R.C. (1998) 5-Year Outcome of Surgical Resection and Watchful Waiting for Men with Moderately Symptomatic BPH. A Department of Veterans Affairs Cooperative Study. The Journal of Urology, 160, 12-16. http://dx.doi.org/10.1016/S0022-5347(01)63011-8
[5]
Roehrborn, C.G. and Mcconnell, J.D. (2007) Benign Prostatic Hyperplasia: Etiology, Pathophysiology, Epidemiology, and Natural History. Campbell-Walsh Urology, 9th Edition, Saunders, Philadelphia.
[6]
Neyer, M., Reissigl, A., Schwab, C., Pointner, J., Abt, D., Bachmayer, C., et al. (2013) Bipolar versus Monopolar Transurethral Resection of the Prostate: Results of a Comparative, Prospective Bicenter Study—Perioperative Outcome and Long-Term Efficacy. Urologia Internationalis, 90, 62-67. http://dx.doi.org/10.1159/000343688
[7]
Madersbacher, S. and Marberger, M. (1999) Is Transurethral Resection of Prostate Still Justified? BJU International, 83, 227-237. http://dx.doi.org/10.1046/j.1464-410x.1999.00908.x
[8]
Hartung, R., Leyh, H., Liapi, C., Fastenmeier, K., and Barba, M. (2001) Coagulating Intermittent Cutting. Improved High-Frequency Surgery in Transurethral Prostatectomy. European Urology, 39, 676-681.
http://dx.doi.org/10.1159/000052526
[9]
Cherrie, R.J., Young, R.A. and Cattolica, E.V. (1997) The Safety of Overnight Hospitalization for Transurethral Prostatectomy: A Prospective Study of 200 Patients. The Journal of Urology, 157, 531-533.
http://dx.doi.org/10.1016/S0022-5347(01)65194-2
[10]
Klimberg, I.W., Locke, D.R., Leonard, E., Madore, R. and Klimberg, S.R. (1994) Outpatient Transurethral Resection of the Prostate at a Urological Ambulatory Center. The Journal of Urology, 151, 1547-1549.
[11]
Feldstein, M.S. and Benson, N.A. (1997) Early Catheter Removal and Reduced Length of Hospital Stay Following Transurethral Prostatectomy: A Retrospective Analysis of 100 Consecutive Patients. The Journal of Urology, 140, 532-534.
[12]
Aslan, G., Celebi, I., Arslan, D. and Esen, A.A. (2002) Early Catheter Removal Following Transurethral Prostatectomy: Overnight Catheterization. Urologia Internationalis, 68, 105-108.
[13]
Chander, J., Vanitha, V., Lal, P. and Ramteke, V.K. (2003) Transurethral Resection of the Prostate as Catheter-Free Day-Care Surgery. BJU International, 92, 422-425. http://dx.doi.org/10.1046/j.1464-410X.2003.04364.x
[14]
Mueller, E.J., Zeidmann, E.J., Desmond, P.M., Thompson, I.M., Optenberg, S.A. and Wasson, J. (1996) Reduction of Length of Stay and Cost of Transurethral Resection of the Prostate by Early Catheter Removal. British Journal of Urology, 78, 893-896. http://dx.doi.org/10.1046/j.1464-410X.1996.01614.x
[15]
Khan, A. (2014) Day Care Monopolar Transurethral Resection of Prostate: Is It Feasible? Urology Annals, 6, 334-339.
http://dx.doi.org/10.4103/0974-7796.140998
[16]
Gordon, N.S.I. (1998) Catheter-Free Same Day Surgery Transurethral Resection of the Prostate. The Journal of Urology, 160, 1709-1712. http://dx.doi.org/10.1016/S0022-5347(01)62390-5
[17]
Agrawal, S.K. and Kumar, A.S. (1993) Early Removal of Catheter Following Transurethral Resection of the Prostate. British Journal of Urology, 72, 928-998.
[18]
Dodds, L., Lawson, P.O., Crosthwaite, A.H. and Wells, G.R. (1995) Early Catheter Removal. A Prospective Study of 100 consecutive Patients Undergoing Transurethral Resection of the Prostate. British Journal of Urology, 75, 755-779.
http://dx.doi.org/10.1111/j.1464-410X.1995.tb07386.x
[19]
Mamo, G.J. and Cohen, S.P. (1991) Early Catheter Removal versus Conventional Practice in Patients Undergoing Transurethral Resection of Prostate. Urology, 37, 519-522. http://dx.doi.org/10.1016/0090-4295(91)80315-X
[20]
Klimberg, I.W., Locke, D.R., Leonard, E., Madore, R. and Klimberg, S.R. (1994) Outpatient Transurethral Resection of the Prostate at a Urological Ambulatory Center. The Journal of Urology, 151, 1547-1915.
[21]
McLoughlin, M.G. and Kinahan, T.J. (1990) Transurethral Resection of the Prostate in the Outpatient Setting. The Journal of Urology, 143, 951-952.
[22]
Chalise, P.R., Agrawal, C.S. and Pandit, R.K. (2007) Reduction of Length of Hospital Stay after Transurethral Resection of Prostate by Early Catheter Removal: A Retrospective Analysis. Nepal Medical College Journal, 9, 84-87.
[23]
Nakagawa, T. and Toguri, A.G. (2006) Early Catheter Removal Following Transurethral Prostatectomy: A Study of 431 Patients. Medical Principles and Practice, 15, 126-130. http://dx.doi.org/10.1159/000090917
