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同一天拔除经尿道钬激光前列腺剜除术导尿管:一项前瞻性研究的结果。

Catheter Removal on the Same Day of Holmium Laser Enucleation of the Prostate: Outcomes of a Pilot Study.

机构信息

Department of Urology, Indiana University School of Medicine, Indianapolis, IN.

Department of Urology, Indiana University School of Medicine, Indianapolis, IN.

出版信息

Urology. 2020 Dec;146:225-229. doi: 10.1016/j.urology.2020.09.038. Epub 2020 Oct 10.

Abstract

OBJECTIVE

To determine if same day catheter removal is feasible in a select population after holmium laser enucleation of the prostate (HoLEP).

METHODS

We performed an analysis of patients undergoing HoLEP at our institution who underwent same-day catheter removal after HoLEP. All HoLEPs were performed with Moses 2.0 Optimized for BPH. Patients were dismissed from postoperative recovery unit to the clinic for catheter removal and voiding trial.

RESULTS

To date, 30 patients have undergone same day catheter removal. Median age is 68.6 years (interquartile range [IQR] 61.8-73.3) and preoperative prostate volume 81 mL (IQR 53-114.8). Median enucleation time was 39.5 minutes (IQR 30.5-53), morcellation time was 5 minutes (IQR 4-12 minutes), and enucleated specimen weight was 52.5 g (IQR 33-81). Twenty-seven (90%) patients successfully voided on the same day without requiring catheter replacement. All patients were catheter free by POD1. For patients who successfully passed their voiding trial, the median time from the end of the procedure to hospital discharge was 2.6 hours (IQR [2.1-2.9]) and from the end of the HoLEP to catheter removal was 4.9 hours (IQR [3.5-6.0]).

CONCLUSION

We present for the first time that same day catheter removal is a feasible option in a select population of patients undergoing HoLEP. With more study, this has the potential for transforming the management of BPH, especially larger glands.

摘要

目的

确定在选择的人群中,经钬激光前列腺剜除术(HoLEP)后是否可以在当天拔除导尿管。

方法

我们对在我院接受 HoLEP 并在 HoLEP 后当天拔除导尿管的患者进行了分析。所有 HoLEP 均采用 Moses 2.0 优化版治疗前列腺增生。患者从术后恢复病房出院到诊所拔除导尿管并进行排尿试验。

结果

迄今为止,已有 30 例患者当天拔除导尿管。中位年龄为 68.6 岁(四分位距 [IQR] 61.8-73.3),术前前列腺体积为 81ml(IQR 53-114.8)。中位剜除时间为 39.5 分钟(IQR 30.5-53),切碎时间为 5 分钟(IQR 4-12 分钟),剜除标本重量为 52.5g(IQR 33-81)。27 例(90%)患者当天成功排尿,无需更换导尿管。所有患者在 POD1 时均无导尿管。对于成功通过排尿试验的患者,从手术结束到出院的中位时间为 2.6 小时(IQR [2.1-2.9]),从 HoLEP 结束到拔除导尿管的中位时间为 4.9 小时(IQR [3.5-6.0])。

结论

我们首次提出,在选择的 HoLEP 患者人群中,当天拔除导尿管是一种可行的选择。随着更多的研究,这有可能改变前列腺增生的管理方式,特别是对较大的前列腺。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f01d/7547315/e79357b7a5ee/gr1_lrg.jpg

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