Dramatically Lowered Risk of Complications
If this were 1991 and you were about to undergo a radical prostatectomy, you would expect to be in the hospital for at least a week. Today, you will most likely go home in one to two days. This and other aspects of postoperative recovery in thousands of patients who underwent radical prostatectomy at Johns Hopkins were studied recently in a review of the changing "clinical care pathway" from surgery to discharge from the hospital. The analysis, by Phillip Pierorazio, M.D.; Jeffrey Mullins, M.D.; Ashley Ross, M.D., Ph.D.; Elias Hyams, M.D.; Alan Partin, M.D., Ph.D.; Misop Han, M.D.; Patrick Walsh, M.D.; Edward Schaeffer, M.D., Ph.D.; Christian Pavlovich, M.D.; Mohamad Allaf, M.D.; and Trinity Bivalacqua, M.D., Ph.D.; was published in the British Journal of Urology.
" Post-operative clinical care
"The postoperative clinical care pathway after radical prostatectomy has changed dramatically over the past 20 years at Johns Hopkins," says Bivalacqua. The decrease in length of stay has been influenced by factors including "improvements in the knowledge of prostatic anatomy and surgical technique pioneered by Walsh, which have improved blood loss during the operation, decreased the rate of blood transfusion – from between 62 and 89 percent in the 1980s to 0.8 to 3.4 percent most recently – and improved patient convalescence." Other factors include improvements in anesthesia and postoperative pain control; a move driven by both physicians and patients to get out of the hospital sooner; and the difficult economic environment and efforts to decrease costs.