{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:06:35Z","timestamp":1789344395151,"version":"build-2803163510"},"reference-count":0,"publisher":"Canadian Urological Association Journal","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CUAJ"],"abstract":"<jats:p>Introduction: Unplanned visits (UPV) \u2014 re-admissions and emergency room (ER) visits \u2014 are markers of healthcare system quality. Radical prostatectomy (RP) is a commonly performed cancer procedure, where variation in UPV represents a gap in care for prostate cancer patients. Here, we systematically synthesize the rates, reasons, predictors, and interventions for UPV after RP, to inform evidence-based quality improvement (QI) initiatives.\r\nMethods: A systematic review was performed for studies from 2000\u20132020 using keywords: \u201cre-admission,\u201d \u201cemergency room\/department,\u201d \u201cunplanned visit,\u201d and \u201cprostatectomy.\u201d Studies that focused on UPV following RP and that reported rates, reasons, predictors, or interventions, were included. Data was extracted via a standardized form. Meta-analysis was completed.\r\nResults: Sixty studies, with 406 107 RP patients, were eligible; 16 028 UPV events (~5%) were analyzed from 317 050 RP patients. UPV rates after RP varied between studies (ER visit range 6\u201324%; re-admissions range 0\u201356%). The 30-day and 90-day ER visit rates were 12% and 14%, respectively; the 30-day and 90-day re-admission rates were 4% and 9%, respectively. A total of 55% of all re-admissions after RP are directly due to postoperative genitourinary (GU)-related complications such as strictures, obstructions, fistula, bladder-related, incontinence, urine leak, renal problems, and other unspecified urinary complications. The next most common re-admission reasons were anastomosis-related, infection-related, cardiovascular\/pulmonary events, and wound-related issues. Thirty-four percent of all ER visits after RP are directly due to urine-related issues such as retention, urinoma, obstruction, leak, and catheter problems. The next most common ER visit reasons were abdominal\/gastrointestinal issues, infection-related, venous thromboembolic events, and wound-related issues. Predictors for increased re-admission included: open RP, lymph node dissection, Charlson comorbidity index\u22652, low surgeon\/hospital case volume, and socioeconomic determinants of health. Of the 10 interventions evaluated, a 3.4% average reduction in UPV rate was observed, highlighting an approximate two-fold decrease. Meta-analysis demonstrated a significant benefit of interventions over controls with odds ratio 0.62 (95% confidence interval 0.46\u20130.84). Interventions that used multidisciplinary, nurse-centered, programs, with patient self-care\/empowerment were more beneficial than algorithmic patient care pathways and preoperative patient education.\r\nConclusions: Twenty years of international, retrospective, experience suggests UPV after RP are often related to GU complications, infection- or wound-related factors. QI interventions to reduce UPV should target these factors. While many re-admissions after RP appear to be unavoidable, ER visits have more opportunity for volume reduction by QI. The interventions evaluated herein have potential to reduce UPV after RP.<\/jats:p>","DOI":"10.5489\/cuaj.6931","type":"journal-article","created":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T09:03:58Z","timestamp":1616144638000},"source":"Crossref","is-referenced-by-count":7,"title":["A systematic review and meta-analysis of unplanned hospital visits and re-admissions following radical prostatectomy for prostate cancer"],"prefix":"10.5489","volume":"15","author":[{"given":"Avinash N.","family":"Mukkala","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine B.","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Boasie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Irish","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Finelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice C.","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3456","published-online":{"date-parts":[[2021,3,18]]},"container-title":["Canadian Urological Association Journal"],"original-title":[],"link":[{"URL":"https:\/\/cuaj.ca\/index.php\/journal\/article\/download\/6931\/4832","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/cuaj.ca\/index.php\/journal\/article\/download\/6931\/4833","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/cuaj.ca\/index.php\/journal\/article\/download\/6931\/4832","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T09:03:59Z","timestamp":1616144639000},"score":1,"resource":{"primary":{"URL":"https:\/\/cuaj.ca\/index.php\/journal\/article\/view\/6931"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,18]]},"references-count":0,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,3,18]]}},"URL":"https:\/\/doi.org\/10.5489\/cuaj.6931","relation":{},"ISSN":["1920-1214","1911-6470"],"issn-type":[{"value":"1920-1214","type":"electronic"},{"value":"1911-6470","type":"print"}],"subject":[],"published":{"date-parts":[[2021,3,18]]}}}