Day surgery in the treatment of benign prostatic obstruction with photoselective vaporisation of the prostate: A single-institution experience

Aim

To assess the feasibility, efficacy and safety of performing photoselective vaporisation of the prostate (PVP) as a day-surgery procedure for patients with benign prostatic obstruction.

Patients and Methods

A prospective single-arm observational study was performed involving patients with benign prostatic obstruction (BPO) who received PVP between 2017 and 2021. Data were collected on demographics, prostate volume by transrectal ultrasonography, mean peak flow rate (Q_max), post-void residual urine volume, International Prostate Symptom Score (IPSS) with quality-of-life (QoL) index, length of stay, success in weaning off catheter on the day of operation and complications.

Results

PVP was performed successfully in all 37 men between 2017 and 2021. Their mean age was 67 years. The mean prostate volume was 54 mL. The mean duration of operation was 80 min. The mean peak urinary flow rate improved from 9.14 to 16.8, 17.3 and 15.4 mL/s at post-operative 1, 3 and 12 months, respectively (P = .001). The mean IPSS score improved from 19.5 to 8.94, 6.40 and 5.63 at post-operative 1, 3 and 12 months, respectively (P < .001). The mean QoL index improved from 4.07 to 2.43, 2.25 and 1.81 at post-operative 1, 3 and 12 months, respectively (P = .001). The mean duration of catheterisation after PVP was 5.81 h. Thirty-three (89.2%) patients were discharged on the same day. Overall, the 30-day complication rate was 27%. The most common complication was haematuria (6 patients, 16.2%). Five patients (13.5%) required readmission and inpatient care. There was one Clavien–Dindo grade III and IV complication (2.6%), respectively.

Conclusion

This study demonstrated the feasibility of performing PVP as a day-surgery procedure with good short- and medium-term functional outcomes and safety profiles.