Ureteroscopy: An Outpatient Procedure?

Abstract

Ureteroscopy is used in the diagnosis and treatment of many urological conditions. The technique of ureteroscopy has been simplified by the introduction of smaller ureteroscopes and by an increase in the variety of accessory instruments that can be passed through the ureteroscope. Despite those advances, recent reports indicate that ureteroscopy is still generally considered an inpatient procedure. Since 1987 we have performed most of our ureteroscopic procedures on an outpatient basis. We reviewed the records of 176 patients who underwent ureteroscopy between 1988 and 1990, of whom 84 (47.7%) underwent extracorporeal shock wave lithotripsy with the same anesthesia. We treated 134 patients (76.1% of the total group) as outpatients, while 20 (11.4%) chose to remain in the hospital overnight for personal reasons, 10 (5.7%) required additional surgery after ureteroscopy and 12 (6.8%) required hospitalization for preexisting medical problems or for problems that resulted from ureteroscopy. Of the 134 patients who were discharged from the hospital on the day of ureteroscopy only 4 (3.0%) required rehospitalization. The addition of extracorporeal shock wave lithotripsy to ureteroscopy during the same period of anesthesia did not increase the need for hospitalization. Ureteroscopy should be considered an outpatient procedure. The decision to hospitalize a patient after ureteroscopy should be based on preexisting medical problems or on problems that result from ureteroscopy. Routine hospitalization for observation is unnecessary.