METHODS: We propose an outpatient daycase method of delivering Rezūm™ under local anaesthetic without sedation, using a prostatic local anaesthetic block and cold local anaesthetic gel instillation into the urethra.
RESULTS: Preliminary results of our first thirteen patients demonstrate the feasibility of this new technique, with a mean pain score of 2.1 out of 10 on a visual analogue scale, a successful trial without catheter in all 13 patients (one patient voided successfully on second trial), a reduction in mean International Prostate Symptom Score (IPSS) from 20.6 to 5.4, and improvement in maximum flow from 8.8 ml/s to 14.4 ml/s. The complications were minor (Clavien-Dindo less than III) and included a UTI, minor bleeding not requiring admission, and retrograde ejaculation.
CONCLUSIONS: We demonstrate that an outpatient local anaesthetic daycase service without sedation is feasible. This can be delivered in a clinic setting, reduce waiting times for BOO surgery, and increase availability of operating theatre for other general anaesthetic urological procedures.
方法:我们提出了一种门诊日间方法,在局部麻醉下无镇静作用下提供Rezm™,使用前列腺局部麻醉块和冷局部麻醉凝胶滴入尿道。
结果:我们最初的13例患者的初步结果证明了这种新技术的可行性,视觉模拟量表上的平均疼痛评分为10分之2.1,在所有13名患者中进行了无导管的成功试验(一名患者在第二次试验中成功排泄),平均国际前列腺症状评分(IPSS)从20.6降低到5.4,最大流量从8.8ml/s提高到14.4ml/s。并发症较小(Clavien-Dindo小于III),包括UTI,轻微出血不需要入院,逆行射精.
结论:我们证明了不使用镇静的门诊局部麻醉日间服务是可行的。这可以在诊所提供,减少BOO手术的等待时间,并增加手术室用于其他全身麻醉泌尿外科手术的可用性。