Daycase urology at Ibadan, Nigeria: A ten year review

Abstract

Introduction: The objective of the study was to report the extent of urological surgeries performed as day cases in a major tertiary hospital in Ibadan and document the outcome. Methods: We retrospectively reviewed the data of all urologic patients treated at the day-case theatre between January 2000 and December 2009. The parameters evaluated were: age, diagnosis, type of surgery/ procedure, anaesthesia administered and the rank of the surgeon. Day case endoscopic procedures as well as prostate biopsies were excluded from the study. Results: In total, 1292 patients were managed, 290 (22.4%) were children aged between 5 days and 15 years while 1002 (77.6%) adults aged between 17 years and 91 years. The majority of the procedures were carried out by the senior registrars (1169 cases, 90.5%) and consultants were involved in 123 cases (9.5%). General anaesthesia was primarily used in children (158 children vs. 4 adults), while local anaesthesia was used only in adults. 131 (45.2%) children had no anaesthesia for circumcision. The most common procedures performed in adults were varicocelectomy (426 cases, 42.5 %), orchidectomy (332 cases, 33.1%), testicular biopsy (120 cases, 12.0%). While in children male circumcision (231cases, 79.7%) was the main procedure performed. Conclusion: The day-case theatre is still suitable for day case urologic procedure in our setting. The common procedures are varicocelectomy, orchidectomy, and open testicular biopsy in the adults. While in children, male circumcision is commonly carried out.

Paediatric day-case surgery in a new paediatric surgical unit in Northwestern Nigeria

“…[18] However, one report found circumcision to be the most common outpatient procedure in children. [10]…”

“…Most of our patients had their surgery done under general anaesthesia as was reported in other studies. [110]…”

“…Our complication rate of 1.1%, with no readmissions and no mortality, is generally comparable with findings in most other reports and has been attributed to careful patient selection. [178910]…”

Modifying and increasing day-case procedures to solve local problems: Experience of a urology unit

“…However, the spectrum of day-case procedures will certainly depend on the prevailing circumstances in the different institutions as demonstrated in other studies 48. In selecting our cases, emphasis was placed on doing as many of the procedures as possible using local anesthesia.…”

“…Furthermore an equipped preoperative holding area was adequately utilized to receive, observe and discharge these patients avoiding admission to the main ward. Across Africa and in institutions where day surgery is practiced, probably all the different models of day-case surgery setup are practiced including separate day-case ward and day-case theater,4–6 day-case ward but no separate day-case theater,7 day-case theater but no day-case ward 8. Many of these authors have demonstrated good outcome measures using these variations with day-case rates of 30.4-65% reported 457.…”