Same-Day Discharge and Postoperative Functional Outcomes After Minimally Invasive Surgical Treatment for Benign Prostatic Obstruction: A Retrospective Single-Center Observational Study

BackgroundMinimally invasive surgical treatments (MISTs) for lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) are increasingly offered as day-case procedures.We evaluated whether a planned same-day discharge pathway for MIST could be delivered in a UK tertiary center and described the functional outcomes recorded in the same patients. MethodsThis retrospective single-center observational study was reported according to Strengthening the Reporting of Observational Studies in Epidemiology (STROBE).It included men who underwent water vapor thermal therapy (WVTT), prostatic urethral lift (PUL), or temporary implantable nitinol device (i-TIND) on a planned same-day discharge pathway between November 2023 and March 2026.The primary outcome was same-day discharge, reported with exact 95% confidence intervals (CIs).Secondary outcomes were changes from baseline to the first postoperative outpatient review in the International Prostate Symptom Score (IPSS), IPSS quality of life (QoL) score, maximum flow rate (Q-max), and post-void residual volume (PVR), together with clinical response, defined separately as an IPSS reduction of ≥3 points and as an IPSS reduction of ≥30%.Paired t-tests and Wilcoxon signed-rank tests were used.Mixed-effects analyses (including one excluding catheter-dependent men) and the WVTT-only analysis gave consistent estimates. ResultsOf 64 men, 58 (90.6%) underwent WVTT, five PUL, and one i-TIND; six (9.4%) were catheter-dependent before surgery.Same-day discharge was achieved in 61 of 63 men with recorded status (96.8%; 95% CI 89.0-99.6).Paired data were available for IPSS and QoL in 23, Q-max in 35, and PVR in 44 patients.At the postoperative review, IPSS had decreased from 23.5 ± 7.1 to 13.5 ± 7.7 (mean change -10.0; 95% CI -13.5 to -6.5) and QoL from 4.4 ± 0.8 to 2.8 ± 1.4 (-1.65; 95% CI -2.27 to -1.03).Q-max increased by 3.7 mL/s (95% CI 1.3 to 6.1), and median PVR fell from 87 to 19 mL (median change -41 mL; p < 0.001).An IPSS reduction of ≥3 points was achieved by 17 of 23 men (73.9%).Mixed-effects and WVTT-only analyses gave consistent estimates. ConclusionsIn this retrospective single-center study, a planned same-day discharge pathway for MIST was delivered for almost all men, and improvements in symptoms, QoL, and voiding parameters were observed among men with paired data at a first postoperative review whose timing was not recorded.These findings are descriptive and hypothesis-generating because follow-up was incomplete; postoperative medication use, complications, and unplanned healthcare use were not systematically documented, and there was no comparison group.Prospective studies with standardized, dated follow-up are needed.