Mp62-07 Predictors of Same-Day Discharge After Single-Port Transvesical Enucleation of the Prostate (Step)

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology IV (MP62)1 May 2024MP62-07 PREDICTORS OF SAME-DAY DISCHARGE AFTER SINGLE-PORT TRANSVESICAL ENUCLEATION OF THE PROSTATE (STEP) Roxana Ramos, Nicolas Soputro, Adriana M. Pedraza, Jaya S. Chavali, Carter Mikesell, Alp T. Beksac, Mohamed Eltemamy, Zeyad R. Schwen, and Jihad Kaouk Roxana RamosRoxana Ramos , Nicolas SoputroNicolas Soputro , Adriana M. PedrazaAdriana M. Pedraza , Jaya S. ChavaliJaya S. Chavali , Carter MikesellCarter Mikesell , Alp T. BeksacAlp T. Beksac , Mohamed EltemamyMohamed Eltemamy , Zeyad R. SchwenZeyad R. Schwen , and Jihad KaoukJihad Kaouk View All Author Informationhttps://doi.org/10.1097/01.JU.0001008904.63948.3b.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Robotic single-port transvesical enucleation of the prostate (STEP) consists of two key steps: adenoma excision and a 360° mucosal flap reconstruction which minimizes postoperative bleeding and irritative symptoms. STEP is indicated for patients with benign prostatic hyperplasia (BPH) and prostates >80 cc per the AUA Guidelines. Moreover, STEP is valuable in the concurrent management of bladder stones and diverticula. The innovative technique has gained popularity among robotic surgeons, with multiple publications highlighting fast recovery, same-day discharge (SDD) rates ranging from 42% to 92%, and minimal postoperative pain and opioid use. Our objective was to identify factors associated with a higher likelihood of SDD after STEP. METHODS: Retrospective single-center analysis of all consecutive STEP cases performed by three surgeons from February 2019 to October 2023. Patients who were pre-planned admissions were excluded. The cohort was categorized into SDD cases and inpatient cases. SDD was defined as patient discharge within the first 8 hours postoperatively. Group comparisons were made and logistic regression was used to identify predictors of SDD. Significance considered at p<0.05. RESULTS: A total of 140 STEP cases were performed successfully without additional ports or conversions. There were 98 planned outpatient cases, of which 77 (79%) were SDD (median length of stay of 4.7 hours), while 21 (21%) required hospitalization (median length of stay of 26.3 hours). Comparing the groups, inpatient cases had higher Charlson Comorbidity Index (CCI) scores, more frequent preoperative recurrent urinary tract infections (UTI), higher estimated blood loss during surgery, more intraoperative complications, longer catheter duration postoperatively, and higher rates of Clavien-Dindo II complications than SDD patients. Multivariate logistic regression identified CCI and preoperative recurrent UTIs as the only predictors associated with SDD after STEP. Notably, there were no major postoperative complications or readmissions in either group. CONCLUSIONS: In our 4.5 year experience with STEP, we found that lower CCI scores and the absence of preoperative recurrent UTIs are significant predictors of SDD. Additionally, those who required hospitalization were usually discharged the next day. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1023 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Roxana Ramos More articles by this author Nicolas Soputro More articles by this author Adriana M. Pedraza More articles by this author Jaya S. Chavali More articles by this author Carter Mikesell More articles by this author Alp T. Beksac More articles by this author Mohamed Eltemamy More articles by this author Zeyad R. Schwen More articles by this author Jihad Kaouk More articles by this author Expand All Advertisement PDF downloadLoading ...