Same-day discharge after holmium laser enucleation facilitated by medical support teams

Written By : Dr. Shravani Dali |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2022-01-24T09:00:11+05:30 | Updated On 24 Jan 2022 9:00 AM IST

Adequate support of healthcare teams alleviates barriers to successful same-day discharge pathway for Holmium Laser Enucleation of the Prostate pathway, according to a recent study published in the Urology.

A group of researchers conducted a study to investigate perceived barriers to successful same-day discharge (SDD) after holmium laser enucleation of the prostate (HoLEP) from the perspective of surgical and nursing staff members.

A 17-question survey was administered to intraoperative and postoperative surgical staff in June 2021 after a six-month period of implementing an SDD holmium laser enucleation of the prostate (HoLEP) pathway with same-day catheter removal. McNemar's and Stuart-Maxwell tests were performed for statistical analysis.

Results of the study are:

Surveys were completed by 30 respondents. The majority of respondents had less than 5 years of surgical experience (63%). Almost all respondents (96%) felt that holmium laser enucleation of the prostate (HoLEP) patients could be discharged safely on the day of surgery. Overall, 60% felt that holmium laser enucleation of the prostate (HoLEP) had a lower risk of postoperative bleeding compared to other transurethral surgeries. There was a significant decrease in the number of respondents that felt apprehensive when comparing initiation of SDD HoLEP pathway to 6-months post-implementation (43% vs 7%, p=0.003). The most common factors causing apprehension both pre-and post-implementation included: degree of hematuria (43% vs 40%, p=0.56), risk of failure of trial of void (40% vs 30%, p=0.26), and risk of readmission or unplanned emergency department (ED) visit (33% vs 30%, p=0.48). There was a significant decrease in the number of respondents who were apprehensive about lack of experience with SDD after HoLEP comparing pre-and post-implementation (20% vs 0%, p=0.01).

Thus, the researchers concluded that while staff report initial apprehension regarding implementation of an SDD HoLEP pathway, adequate support to intraoperative and postoperative teams helps build an experience that alleviates these concerns.

Reference:

Barriers to implementation of a same-day discharge pathway for Holmium Laser Enucleation of the Prostate by Jenny Guo, et al. published in the Urology.

https://www.goldjournal.net/article/S0090-4295(21)01184-5/fulltext

holmium laser enucleationprostate-glandBarrierssame-day dischargeUrology

Source : Urology

Dr. Shravani Dali

Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751