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Day-case monopolar and bipolar transurethral resection of the prostate

Reviewed by Ann Crump

The aim of this study was to assess the safety and efficacy of performing monopolar (mTURP) and bipolar transurethral resection of prostate (bTURP) as a day-case. This was a prospective two-centre study. One centre performed day-case mTURP (group M) and the other day-case bTURP (group B). Criteria for a day-case procedure were: prostate size <60g, co-morbidities suitable for day-case, patient able to perform catheter care and a responsible adult carer to be present at home for the first 24 hours. Patients were either the first or second case on the morning list and had either a general or spinal anaesthetic. In both centres normal saline irrigation (0.9%) was used in recovery initially until the urine became clear or rose. Patients were then mobilised and discharged home the same afternoon or evening before 19:00 with a spigotted three-way catheter in situ on free drainage. The catheter was then removed 48 hours later, in group M by a district nurse in the community, and in group B by the urology ward nurses. Routine follow-up was only arranged if there was non-benign histology, persistent problems or if the patient was re-referred by their GP. In total 50 men were in Group M and 27 in Group B. No statistical difference was found between the admission and readmission rate. In both groups 92% of patients were able to be discharged as day-cases. Reasons for admission were ongoing haematuria, social reasons or postoperative confusion. The success of the first trials without catheter (TWOC) was 88% in group M and 100% in group B. This study suggests that both methods lead to a reduction in hospital stay with comparable outcomes. This is obviously a small number of patients but I think that this is topical considering the recent NICE recommendation of TURis as a means of reducing patient stay and complication rates. 

Day-case monopolar and bipolar transurethral resection of the prostate.
Bright E, Stocker M, Koupparis A, MacDermott .
JOURNAL OF CLINICAL UROLOGY
2015;8(1):63-7.
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