title: Outpatient Robotic Radical Prostatectomy: Matched-Pair Comparison with Inpatient Surgery.
abstract: OBJECTIVE
  To evaluate our initial experience with outpatient robotic radical prostatectomy (RRP) and to prospectively compare outcomes with an inpatient RRP group.
  
  
  METHODS
  We conducted a prospective study on 30 carefully selected, motivated patients consenting for outpatient RRP (2011-2013). Inclusion criteria comprised age<65 years, American Society of Anesthesiologists score<3, body mass index<35 kg/m2, localized prostate cancer, and primary treatment. Postoperatively, close monitoring was conducted by telephone for the first 24 hours, with routine follow-up subsequently. This outpatient group was prospectively matched 1:1 with a concurrent inpatient RRP group who satisfied inclusion criteria for, but did not undergo, outpatient RRP. Validated questionnaires were administered prospectively to determine patient satisfaction and functional outcomes.
  
  
  RESULTS
  All outpatient RRP procedures were performed effectively. Twenty-six patients (87%) were discharged the same day of surgery, four stayed overnight for various reasons. On comparing outpatient and inpatient groups, there were no significant demographic or perioperative differences, except for shorter hospital stay (14 hours vs 44 hours, p<0.01). In both groups, 92% of patients were completely continent (no pads) at 2 months follow-up. Time to complete continence in the outpatient and inpatient groups was 32 days vs 43 days (p=0.09). Validated questionnaires revealed both groups were comparable as regards patient/family satisfaction, days of narcotic usage, days to return to work, and days to feeling 100% recovered.
  
  
  CONCLUSIONS
  Our initial experience with outpatient RRP is promising. Outpatient RRP is associated with excellent patient satisfaction and functional outcomes comparable with inpatient RRP. Patient motivation and preoperative counseling are vital for success.
authors.affiliation: Catherine & Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California , Los Angeles, California.
authors.forename: Andre K
authors.initials: AK
authors.lastname: Berger
authors.affiliation: Catherine & Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California , Los Angeles, California.
authors.forename: Sameer
authors.initials: S
authors.lastname: Chopra
authors.affiliation: Catherine & Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California , Los Angeles, California.
authors.forename: Mihir M
authors.initials: MM
authors.lastname: Desai
authors.affiliation: Catherine & Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California , Los Angeles, California.
authors.forename: Monish
authors.initials: M
authors.lastname: Aron
authors.affiliation: Catherine & Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California , Los Angeles, California.
authors.forename: Inderbir S
authors.initials: IS
authors.lastname: Gill
mesh_terms: D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D017060:Patient Satisfaction; D011300:Preoperative Care; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods* / Q000706:statistics & numerical data; D011471:Prostatic Neoplasms / Q000601:surgery; D065287:Robotic Surgical Procedures / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D016896:Treatment Outcome