Ureteroscopy as an out-patient procedure: the Singapore General Hospital Urology Centre experience.

OBJECTIVE To study the safety and efficacy of ureteroscopy as an out-patient procedure. DESIGN Retrospective study. SETTING Teaching hospital, Singapore. SUBJECTS AND METHODS Operating facilities for out-patient ureteroscopy were introduced in late 1998. A retrospective review of all patients undergoing ureteroscopy from March 1999 to December 2000 was conducted. Clinical records were reviewed for operating time, surgical outcome and complications, and length of hospital stay and re-admissions. RESULTS Two hundred and ten patients underwent ureteroscopy for a variety of indications--115 patients were admitted to hospital as in-patients and 95 patients were treated as out-patients. Ureteroscopy and laser lithotripsy were performed using general or regional anaesthesia. Patients assessed to be American Society of Anesthesiology class I or II were eligible for an out-patient procedure. American Society of Anesthesiology class was found to be lower for those treated as out-patients compared with those undergoing in-patient procedures--63% versus 28% for class I and 36% versus 69% for class II. Mean operating time was 37 minutes for out-patient procedures and 57 minutes for in-patient procedures (P<0.01). Complications were low for out-patients, with six unplanned re-admissions, mostly for minor complications. All patients were discharged the following day. CONCLUSION Ureteroscopy can be offered selectively as an out-patient procedure to patients with low surgical risk, especially American Society of Anesthesiology class I patients, and others expected to have an uncomplicated surgical procedure.