The safety and efficacy of ambulatory urologic surgery

A paradigm shift towards optimizing resource use in outpatient settings

Authors

  • Dhiraj S. Bal Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada https://orcid.org/0000-0003-3570-7535
  • David Chung Section of Urology, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada
  • Harliv Dhillon Men’s Health Clinic Manitoba, Winnipeg, MB, Canada
  • Maximilian Fidel Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
  • Jainik Shah Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
  • Alagarsamy Pandian Department of Anesthesiology, University of Manitoba, Winnipeg, MB, Canada
  • Jasmir G. Nayak Section of Urology, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada & Men’s Health Clinic Manitoba, Winnipeg, MB, Canada
  • Premal Patel Section of Urology, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada & Men’s Health Clinic Manitoba, Winnipeg, MB, Canada

DOI:

https://doi.org/10.5489/cuaj.8806

Keywords:

Ambulatory Surgery, Ambulatory Surgery Center, Healthcare Infrastructure

Abstract

INTRODUCTION: Amid substantial surgical wait lists, novel methods are needed to improve the delivery of surgical care in Canada. One strategy involves shifting select surgeries from hospitals into community ambulatory centers, which expedite procedures and allow hospitals to prioritize critical and complex patients. We sought to evaluate surgical outcomes at a novel, Canadian urologic clinic and surgical center.

METHODS: A retrospective study was conducted at a novel, accredited surgical facility and outpatient ambulatory clinic from August 2022 to August 2023. Procedures ranged from scrotal and transurethral surgeries to inflatable penile prosthesis insertion. Traditional outpatient procedures, including vasectomy and cystoscopy, were excluded. All patients were discharged the same day and seen 4–6 weeks post-procedure. Variables of interest included surgery type, anesthesia administered, additional clinic appointments, unplanned family physician appointments, visits to the emergency department (ED), and hospital admissions.

RESULTS: In a 12-month period, 519 surgeries were performed. The mean patient age was 49.6±17.3 years, with most classified as American Society of Anesthesiologists (ASA) 1–2 (88.8%). Most (95.8%, n=497) patients did not require medical care outside the clinic before their scheduled followup; 2.5% (n=13) visited the ED presenting for wound concerns, postoperative pain, query infection, or catheter-related concerns. Only 1.7% (n=9) required an unscheduled appointment with their family physician, with concerns being inadequate postoperative pain management (n=4) or suspected infection (n=4). No patient required hospital admission.

CONCLUSIONS: Many urologic surgeries classically performed in hospital operating rooms can be safely performed in a non-hospital, outpatient surgical facility with preservation of good outcomes. This strategy can potentially improve the efficiency of urologic healthcare delivery in select patients.

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Published

2024-07-15

How to Cite

Bal, D. S., Chung, D., Dhillon, H., Fidel, M., Shah, J., Pandian, A., … Patel, P. (2024). The safety and efficacy of ambulatory urologic surgery: A paradigm shift towards optimizing resource use in outpatient settings. Canadian Urological Association Journal, 18(12), 393–7. https://doi.org/10.5489/cuaj.8806

Issue

Vol. 18 No. 12 (2024): CUAJ December

Section

Original Research

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