Prostate surgery involves procedures addressing conditions of the prostate gland, a small organ in men located below the bladder. These conditions include benign prostatic hyperplasia (BPH), a non-cancerous enlargement that can obstruct urine flow, or prostate cancer, which involves abnormal cell growth. The surgical approach depends on the condition and its severity. The objective is to alleviate symptoms, restore urinary function, or remove cancerous tissue.
Prostate Surgery Types and Typical Stays
Prostate surgery includes different procedures, and hospital stay length varies by type. Transurethral Resection of the Prostate (TURP) is a common surgery for BPH, where excess prostate tissue is removed through the urethra. Patients undergoing TURP stay one to three days.
For prostate cancer, a radical prostatectomy involves removing the entire prostate gland. This is an inpatient procedure; robotic-assisted radical prostatectomy requires a hospital stay of one to two days, while open surgery necessitates three to four days.
Minimally invasive options for BPH, such as UroLift and Rezum water vapor therapy, are performed on an outpatient basis. Patients undergoing a UroLift procedure go home the same day and do not require a catheter after treatment. Rezum therapy allows for same-day discharge. Laser ablation for BPH can be an outpatient procedure or involve an overnight hospital stay.
Factors Influencing Outpatient Suitability
Whether prostate surgery can be performed as an outpatient procedure depends on factors beyond the surgery type. A patient’s overall health plays a role, as individuals with fewer co-existing medical conditions are better candidates for same-day discharge. Age can also be a consideration, with younger patients being more suitable for outpatient settings. The surgical technique, such as a minimally invasive robotic approach, can contribute to a shorter recovery and outpatient status.
The complexity of the case, including prostate size or condition extent, also influences the decision. Surgeon preference and support at home are considerations for safe discharge. Some facilities may require patients to live within a certain proximity to the hospital or have a caregiver present overnight following surgery. These factors are evaluated to determine suitability for an outpatient procedure.
The Outpatient Surgical Experience
For outpatient prostate surgery, patients can expect a clear process on the day of the procedure. Upon arrival, pre-operative checks are completed, and patients follow instructions to avoid eating or drinking for hours prior. Anesthesia, ranging from local with sedation to general, is administered to ensure comfort during the procedure.
After surgery, patients are moved to a post-anesthesia care unit (PACU) for monitoring as they recover from anesthesia. Once awake, stable, and pain is controlled, they are assessed for discharge. Criteria for going home include being able to urinate on their own, maintaining stable vital signs, and being able to tolerate fluids. Patients are then discharged to the care of a family member or friend, as driving is not permitted after anesthesia.
Recovering at Home After Outpatient Prostate Surgery
Upon returning home after outpatient prostate surgery, patients will experience a recovery period. It is common to feel discomfort, fatigue, and notice changes in urinary patterns, including blood in the urine, for several days or weeks. If a catheter was placed during the procedure, instructions for its care at home will be provided, including how to manage the drainage bag and maintain hygiene.
Catheter duration varies: less than 24 hours for some laser procedures, one to three days for TURP, three to seven days for Rezum, and one to two weeks for radical prostatectomy. Activity restrictions are in place for a few weeks, involving avoiding strenuous exercise, heavy lifting, and driving. Pain can be managed with over-the-counter medications or prescribed pain relievers. Patients should monitor for signs of complications, such as thick blood in the urine, fever, worsening pain, or inability to urinate, and contact their medical team if these occur. Follow-up appointments are scheduled to monitor recovery and address any ongoing concerns.