REDUCTION OF LENGTH OF STAY AND COST OF TRANSURETHRAL RESECTION OF THE PROSTATE BY EARLY CATHETER REMOVAL

Objective To determine whether early removal of the indwelling Foley c atheter after transurethral resection of the prostate (TURF) significa ntly shortens the hospital stay without causing additional morbidity a nd thus saves costs. Patients and methods For the year commencing 1 Ju ly 1991, 119 patients who had undergone TURF had their indwelling cath eter removed on the first day after surgery. The results and morbidity of this group of patients were compared with those in 152 patients un dergoing TURP during the previous pear. The economic consequences of t his protocol were calculated using both Medicare and CHAMPUS data. Res ults The demographics of the patients in both groups were similar. Pos t-operative complications occurred in 5% of the study patients and in 6.6% of controls; a transfusion was required in 2.5% and 1.3%, clot re tention developed in 1.7% and 3.3% and the hospital stay was reduced f rom 3.1 to 1.28 days in the study and control patients, respectively, Using Medicare data, the mean cost saving of early catheter removal wo uld be $829 and $1406 for patients aged <70 and >70 years, respectivel y, For CHAMPUS patients. the cost saving would be $1983. Conclusion Ea rly removal of the catheter after TURF did not increase morbidity and maintained the efficacy of the procedure. If this practice was adopted nationally, the savings resulting from the reduction in hospital stay would be considerable.