Enucleação prostática por Holmium laser (HoLEP) ambulatorial sem cateter vesical: avaliação da viabilidade e segurança

Abstract

Objective: to evaluate feasibility, safety and predictive factors for success or failure in the use of Holmium laser for enucleation of prostatic adenomas (HoLEP) with early hospital discharge and removal of the bladder catheter, less than twelve hours from the start of the procedure. Materials and Methods – Prospective cohort study with a convenient sample in which 34 HoLEP surgical procedures were performed using 60w holmium laser devices and a piranha morcellator. Surgeries began at 10:30 am and hospital discharge was scheduled for 5 pm on the same day. Patients underwent a urination test to remove the bladder catheter before hospital discharge. Functional results were also evaluated 90 days after the procedures. Results: 34 patients were included in the study. The mean age, PSA and prostate volume were 63.4 years (50 – 80 years); 4.81ng/ml (0.19 – 14ng/dl) and 89.3g (33 – 258g), respectively. The average adenoma enucleation time was 56.2 minutes (29 – 91 min) and morcellation time was 14.67 minutes (3 – 45 min). 31 patients (91.1%) were discharged on the same day as the procedure without a bladder catheter. Conclusion: performing HoLEP on an outpatient basis is safe. Removing the bladder catheter on the same day of the procedure is feasible and does not affect hospital discharge.