Clinical Report: Feasibility and Safety of Same-Day Laser Prostate Enucleation

Overview

This systematic review evaluates the feasibility and safety of same-day discharge following laser endoscopic enucleation of the prostate (EEP) for benign prostatic enlargement (BPE). The analysis of 15 studies indicates that same-day laser EEP is a viable and safe option with comparable functional outcomes and low complication rates.

Background

Benign prostatic enlargement (BPE) causes lower urinary tract symptoms (LUTS) that worsen with age and impact quality of life. Laser endoscopic enucleation of the prostate (EEP) has emerged as an effective surgical treatment alternative to traditional methods such as TURP and open prostatectomy, offering advantages including lower morbidity and shorter hospital stays. Given the benefits of reduced hospital stay, including decreased perioperative complications and healthcare costs, the feasibility of same-day discharge after laser EEP has gained research interest. This review systematically assesses the safety and functional outcomes of same-day discharge in patients undergoing laser EEP.

Data Highlights

Key Findings

• Laser EEP is effective regardless of prostate size and shows low morbidity, including reduced intraoperative bleeding and transfusion rates.
• Same-day discharge after laser EEP is feasible with functional outcomes (IPSS, Qmax, PVR) comparable to inpatient procedures.
• Perioperative complication rates are low and similar between same-day discharge and inpatient groups, with Clavien–Dindo classification used for assessment.
• Hospital readmission rates after same-day discharge are low, with documented reasons and effective management strategies.
• Quality of evidence varies, with several studies rated as high or good quality supporting the safety of same-day laser EEP.
• Shorter hospital stays reduce medical expenses and risk of nosocomial infections, enhancing patient recovery and healthcare efficiency.

Clinical Implications

Clinicians can consider same-day discharge protocols for patients undergoing laser EEP, given the demonstrated safety and comparable functional outcomes. Careful patient selection and perioperative management are essential to minimize complications and readmissions. Implementing same-day surgery pathways may reduce healthcare costs and improve patient satisfaction without compromising clinical efficacy.

Conclusion

Same-day discharge after laser endoscopic prostate enucleation is a safe and effective approach for managing BPE, offering comparable functional outcomes and low complication rates. This strategy supports enhanced recovery and resource optimization in urologic surgery.

References

1. Gilling et al. 1998 -- Initial description of laser EEP
2. PRISMA Statement 2009 -- Preferred Reporting Items for Systematic Reviews and Meta-Analyses
3. NIH Quality Assessment Tool -- Study Quality Evaluation