The aim of this study was to assess the safety and efficacy of performing monopolar (mTURP) and bipolar transurethral resection of prostate (bTURP) as a day-case. This was a prospective two-centre study. One centre performed day-case mTURP (group M) and the other day-case bTURP (group B). Criteria for a day-case procedure were: prostate size <60g, co-morbidities suitable for day-case, patient able to perform catheter care and a responsible adult carer to be present at home for the first 24 hours. Patients were either the first or second case on the morning list and had either a general or spinal anaesthetic. In both centres normal saline irrigation (0.9%) was used in recovery initially until the urine became clear or rose. Patients were then mobilised and discharged home the same afternoon or evening before 19:00 with a spigotted three-way catheter in situ on free drainage. The catheter was then removed 48 hours later, in group M by a district nurse in the community, and in group B by the urology ward nurses. Routine follow-up was only arranged if there was non-benign histology, persistent problems or if the patient was re-referred by their GP. In total 50 men were in Group M and 27 in Group B. No statistical difference was found between the admission and readmission rate. In both groups 92% of patients were able to be discharged as day-cases. Reasons for admission were ongoing haematuria, social reasons or postoperative confusion. The success of the first trials without catheter (TWOC) was 88% in group M and 100% in group B. This study suggests that both methods lead to a reduction in hospital stay with comparable outcomes. This is obviously a small number of patients but I think that this is topical considering the recent NICE recommendation of TURis as a means of reducing patient stay and complication rates. 

Day-case monopolar and bipolar transurethral resection of the prostate.
Bright E, Stocker M, Koupparis A, MacDermott .
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Ann Crump

Central Manchester Foundation NHS Trust

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