MARY STOCKER & SEAMUS MACDERMOTT
(This article was originally published in the Journal of One-Day Surgery Vol. 23 No. 4, 2013. It was Number 7 in the 'How i Do It' series, updated in 2020)
Patient Selection
- Select patients who will cope with catheter at home
- Limit to prostates of moderate size
Anaesthetic Techniques
• Spinal anaesthetic:
• 2-3mls (40-60mg) 2% hyperbaric prilocaine
• 1.5mls 0.5% (7.5mg) hyperbaric bupivacaine
• Or short acting general anaesthesia
Surgical Technique
- IV antibiotics at induction
- Standard monopolar or bipolar TURP
- Ensure systolic BP >100
- Close attention to haemostasis
- 3-way catheter for irrigation if needed
- Mobilise after 1-2 hours or spinal block worn off
Peri-operative Analgesia
- Pre-operative: oral paracetamol (1g) and ibuprofen (1600mg slow release)
- Intra-operative: iv fentanyl if spinal not used
- Post operative: regular paracetamol and ibuprofen
- Rescue intravenous fentanyl or oral morphine if required
Take Home Medication
- Paracetamol 500 mg/ codeine 30mg po qds, laxido 1 sachet bd, plus ibuprofen 600 mg po qds
Organisational Issues
- Catheter removed by district nurse next working day before 10am
- Appointment with urology nurses that afternoon after 4pm for symptom check/ bladder scan
- Notes to urology office to await histology
Anticipated Day Case Rates