To report a single centre's experience of the feasibility, safety and patient acceptability of same-day discharge robot-assisted laparoscopic prostatectomy (RALP). Subjects/Patients and MethodsBetween June 2015 and December 2021, a total of 180 pre-selected consecutive patients underwent RALP with the intention to discharge on the same day as surgery. Cases were performed by two surgeons. An enhanced recovery after surgery (ERAS) programme was used. The feasibility of same-day discharge was analysed, along with the complication rate, oncological outcomes, and postoperative patient experience. ResultsOf 180 patients, 169 (93.8%) were successfully discharged on the same day as surgery. The median (range) age was 63 ( 44-74) years. The median (range) console time was 97 (61-256) min and blood loss was 200 (20-800) mL. The resection specimen pathology results were: pT2 69.4%, pT3a 24.4% and pT3b 6.5%. With regard to Gleason Grade Group (GGG), 25.9% had GGG 1, 65.7% had GGG 2-3 and 8.4% had GGG 4-5 disease. Positive surgical margins were present in 25 cases (14.7%), 18 (15.5%) of which occurred in pT2 cases, and seven (13.4%) in pT3 cases. There were no early (<90 days) biochemical relapses (defined as prostate-specific antigen level >0.2 ng/mL). The 30-day readmission rate was 3%. A total of 13 early (0-30 days) complications were observed, five of which were Clavien-Dindo grade ≥3, however, none of these would have been avoided had the patient remained in hospital on the first postoperative night. Of 121 consecutive patients, 107 (88%) returned a satisfaction questionnaire, and 92% of responders stated they preferred recovery at home, with 94% stating they felt ready to go home. ConclusionRobot-assisted laparoscopic prostatectomy combined with an ERAS programme allows patients to be safely discharged home on the same day of their surgery. This is a feasible option, well-liked by patients, with morbidity and oncological outcomes similar to non-day-case or 23 h stay RALP.

Granulomatosis with polyangiitis (GPA) is an autoimmune small to medium vessel inflammatory vasculitis that can affect multiple organ systems, with predominantly pulmonary, renal and musculoskeletal manifestations. Rarely, there have been cases involving the genitourinary system, particularly causing urethritis and prostatitis. In some incidences, this may mimic prostate abscess or malignancy. We present a case of a 36-year-old man with refractory urinary retention secondary to prostate abscess due to GPA. This case necessitated transurethral resection of the prostate (TURP) and supra-pubic catheterisation, later complicated by a peri-anal abscess and severe urethritis. A potential recto-urethral fistula was noted on magnetic resonance imaging (MRI) and cystourethroscopy, which was managed conservatively with long-term catheter drainage until resolution. The patient ultimately displayed many severe clinical manifestations of a systemic vasculitis and this case report emphasises the importance of considering autoimmune vasculitis conditions as a differential diagnosis when managing inflammatory genitourinary conditions. This case report highlights the importance of obtaining sufficient tissue to make a timely diagnosis in order to initiate immunosuppressant therapy and disease-modifying anti-rheumatic drugs (DMARDs).