Preoperative Indication Meetings Optimise Outcomes in Elective Urological Surgery
DOI:
https://doi.org/10.12669/pjms.42.10.20062Keywords:
Elective urology, preoperative assessment,, Indication meetings, surgical planning, perioperative outcomesAbstract
Background & Objective: Elective urological surgery involves risks beyond the technical aspects. Structured preoperative indication meetings provide a forum for comprehensive review, risk assessment, and patient-centred optimisation. To evaluate the impact of structured preoperative indication meetings on surgical planning, modification patterns, and short-term perioperative outcomes in elective urology.
Methodology: A prospective observational study conducted at a university hospital from June 2024 to May 2025. Adult patients (≥18 years) scheduled for elective urological procedures across various subspecialties were included. Weekly online preoperative meetings reviewed demographics, comorbidities and surgical plans etc. Modifications were classified as major or minor. Cases were monitored for 30 days postoperatively to assess complications, readmissions, etc. Multivariable logistic regression analyses identified factors predicting changes in surgical plans. Statistical significance set at p < 0.05.
Results: Among 703 analysed cases, 147 (20.9%) underwent modifications after review. Older age (>50 years), male gender, comorbidities, history of addiction, anticoagulation therapy, higher ASA scores, and endoscopic procedures were linked to plan changes (p < 0.01). Major modifications accounted for 25.8%, while minor modifications made up 74.2%. Additional counselling (27.2%) and diagnostic imaging (17.3%) were the most common reasons for changes. Multivariable analysis identified male gender (OR 3.61), addiction (OR 5.53), ASA III (OR 3.34), anticoagulation (OR 4.52), and procedure type as independent predictors. Postoperative complications were low (1.8%), mostly minor, and there was no perioperative mortality.
Conclusion: Structured preoperative indication meetings improve surgical planning, patient selection, and perioperative preparedness, serving as a safety net for high-risk patients and supporting evidence-based, patient-centred urological care.
