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Introduction: Though laser prostatectomy is becoming more commonplace, many patients are admitted postoperatively. We investigated the feasibility and safety of a rapid ambulatory discharge pathway following holmium laser ablation of the prostate (HoLAP) for the treatment of benign prostatic hyperplasia (BPH).
Materials & Methods: Between January 2007 and December 2009, 65 patients underwent HoLAP scheduled as a day surgical case by one surgeon. Patients were discharged from day surgery with a straight drainage catheter in place. Voiding trial occurred on postoperative day 3. Preoperative, intraoperative, and postoperative parameters within the 90 day global period were reviewed. Statistical analysis employed the Student's t-test with a two-tailed significance level of 0.05.
Results: The mean patient age was 64. Average ASA score was 2.2. Mean operative time was 44 minutes. Mean postoperative time until discharge was 2 hours 29 minutes. There were no readmissions after discharge. Within the 90-day global period, 13 patients described LUTS, 5 patients had post-operative urinary retention, and one patient had a UTI. Average AUA Symptom Score decreased from 21.3 to 7.6 postoperatively (p<0.0001). Average quality of life score decreased from 4.04 to 1.38 (p<0.0001) postoperatively. Average post-void residual decreased from 190.2 to 46.4 ml postoperatively (p<0.0005).
Conclusions: In appropriately selected patients, a rapid ambulatory pathway HoLAP can be safely performed with minimal mobidity in the global period.