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Observational Study
. 2021 May;28(5):514-518.
doi: 10.1111/iju.14493. Epub 2021 Feb 22.

Day-case catheterless and drainless minimal-access pyeloplasty in adults: A single-center experience of 13 years

Vinodh Murali  1 , Jack Donati-Bourne  2 , Megan Thomas  1 , Christopher Luscombe  1 , Anurag Golash  1 , Herman Fernando  1
Affiliations
Observational Study

Day-case catheterless and drainless minimal-access pyeloplasty in adults: A single-center experience of 13 years

Vinodh Murali et al. Int J Urol. 2021 May.

Abstract

Objectives: To analyze our practice of drainless and catheterless day-case minimal-access pyeloplasty with regard to feasibility, safety and long-term outcomes.

Methods: Patients undergoing minimal-access pyeloplasty (laparoscopic, with or without robotic assistance) in a single center between 2007 and 2020 were included in this retrospective observational study. Patient demographics and the success rate of day-case discharge along with postoperative outcomes were analyzed.

Results: A total of 129 patients underwent minimal-access pyeloplasty in this time period, of whom 116 met the inclusion criteria. The mean patient age was 48 years. A total of 65% of the patients (n = 75) were discharged on the same day and 88% (n = 101) were discharged within 23 h of surgery. Of the 14 patients with a hospital stay of >24 h, pain was the most common reason (60%) for delayed discharge. The overall subjective (pain-free status) and objective (unobstructed drainage) success rates were 91% and 86%, respectively.

Conclusion: This study demonstrates that routine drains or urethral catheters are not necessary in minimal-access pyeloplasty, and their omission could facilitate early recovery and day-case discharge without compromising long-term surgical outcomes. Large randomized controlled studies are required to prospectively evaluate outcomes.

Keywords: catheterless; day-case surgery; drainless; minimal-access pyeloplasty; robot-assisted pyeloplasty.

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