Reasons for cancellations of urologic day care surgery

Abstract

Objective : The numerous economic and social benefits associated with the practice of day care surgery could be eroded by frequent cancellations. We therefore determined the reasons for such cancellations in a tertiary care centre in Nigeria. Patients and Methods : This was a prospective study of all consecutive urologic day cases seen at Jos University Teaching hospital, Nigeria from January 2003 to December 2004. Results : A total of 270 patients were seen during the study period with ages from 2 weeks to 100 years (median 55 years) and male to female ratio of 14:1. The procedures carried out were mainly urethroscopy /urethrocystoscopy in 103 (38.2%) patients, visual internal urethrotomy in 48 (17.8%) and trucut prostatic biopsy in 33 (12.2%) patients. Sixteen (5.9%), 16(5.9%), 9(3.3%) and 8(3.0%) patients had examination under anaesthesia / bladder biopsy for suspected bladder carcinoma, urethral dilatation, testicular biopsy and total orchidectomy for carcinoma of the prostate respectively. There was a cancellation rate of 15.6% (n=42) mainly due to the inability of the patients to come (24 patients, 57.1%), inadequate materials in the theatre (9 patients, 21.4%), power failure (4 patients, 9.5%), strike action (3 patients, 7.1%) and financial difficulties (2 patients, 4.8%). Conclusion : We are still faced with a high cancellation rate of urologic day cases and these are mainly due to avoidable reasons. Patient as well as physician education and provision of adequate materials and infrastructural development are recommended to reduce these; so as to gain maximally from urologic day surgery practice.