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Tag: benign prostatic hyperplasia

Switching to Outpatient Surgery for Everyone’s Benefit

By AMY KRAMBECK, MD

The trend toward less invasive procedures, shifting from inpatient to outpatient, has changed the face of surgery. Industry-changing leaps in technology and surgical techniques have allowed us to achieve our treatment goals with smaller incisions, laparoscopy and other “closed” procedures, less bleeding, less pain, and lower complication rates. As a result, patients who used to require days of recovery in the hospital for many common surgeries can now recuperate in their own homes.

Outpatient procedures grew from about 50% to 67% of hospitals’ total surgeries between 1994 and 2016,1,2 and outpatient volume is expected to grow another 15% by 2028,3 with advantages for patients, surgeons, insurers, and hospitals. In my hospital, where bed space is at a premium, my colleagues and I were able to make a significant impact by switching minimally invasive surgery for enlarged prostate, also called benign prostatic hyperplasia (BPH), from inpatient to outpatient.

New Opportunity with an Advanced Technology

BPH affects about half of men in their 50s, with the prevalence increasing with age to include about 90% of men 80 and older.4 As a result, BPH surgery makes up a significant portion of urological procedures in any hospital.

I have been performing BPH surgery for 11 years. There are several options, including transurethral resection of the prostate (TURP) and suprapubic prostatectomy, both of which require hospital stays and bladder irrigation with a catheter due to bleeding. Another less frequently utilized surgical option for BPH is holmium laser enucleation of the prostate (HoLEP). HoLEP causes fewer complications and requires shorter hospitalization.5 Specifically, its postoperative morbidity is the lowest among BPH surgeries.5,6,7  HoLEP has the least bleeding, shortest catheter time, and low rates of urinary tract infection, plus patients are less likely to require additional treatment for BPH as they age compared to other available therapies.5,6,7  

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