LBA01-01 UROLIFT PUL COMPARED TO REZUM, TURP AND GREENLIGHT PVP: US MEDICARE AND COMMERCIAL CLAIMS ANALYSIS REVEALS LOWEST COMPLICATIONS FOR PUL AND HIGHEST RETREATMENT FOR REZUM

Abstract

You have accessJournal of UrologyLate-breaking Abstract I - Benign1 Sep 2021LBA01-01 UROLIFT PUL COMPARED TO REZUM, TURP AND GREENLIGHT PVP: US MEDICARE AND COMMERCIAL CLAIMS ANALYSIS REVEALS LOWEST COMPLICATIONS FOR PUL AND HIGHEST RETREATMENT FOR REZUM Steven Kaplan, and Daniel Rukstalis Steven KaplanSteven Kaplan More articles by this author , and Daniel RukstalisDaniel Rukstalis More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002148.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Real world data will address many questions about how new BPH therapies compare to each other and traditional surgeries. Retreatment and complication rates are at the center of the debate, but it is difficult to compare controlled trials with significant differences in concept and execution. By performing a large-scale observational analysis of Medicare and commercial claims, we assess the real world rates of surgical retreatment and post-operative complications endured by LUTS/BPH patients. METHODS: Patient-level data on men with a BPH diagnosis who received TURP, GreenLight PVP, UroLift Prostatic Urethral Lift (PUL) or Rezum steam injection in an outpatient setting from 2015-2019 were analyzed in the representative sample of Medicare and commercial claims (IBM Watson). Surgical retreatment was defined as undergoing TURP, GreenLight, PUL, Rezum, or HoLEP following the index procedure. Complications were secondary procedures with a CPT or ICD10-PCS code. Rates for surgical retreatment and complications were calculated via cumulative incidence curves with logrank tests. Cox regression models accounted for covariates such as index cost and age and assessed the hazard of encountering a retreatment or complication. RESULTS: 18,794 TURP, 9,894 Greenlight, 4,639 PUL and 780 Rezum were included in the database. Over 4 yrs, 9.5% of Rezum patients had a surgical retreatment, which was higher than retreatment after TURP (6.3%), GreenLight (7.0%), and PUL (6.8%) (p=0.004). At 300 d, complication rates were highest after Rezum (23%) and lowest after PUL (16%). The hazard for a complication through 1 year following PUL was 72% lower than Rezum, 69% lower than GreenLight, and 51% lower than TURP. The hazard for retreatment following PUL was similar to TURP and GreenLight, but was 66% and 45% lower than Rezum at 1 and 5 years, respectively. CONCLUSIONS: Large-scale analysis of real world data is an optimal method for comparing approved BPH treatments, allowing patients and providers to make informed choices. This analysis reveals that complications are lowest after PUL. While retreatment is similar among PUL, TURP and GreenLight, the real world surgical retreatment rate is highest for Rezum. Our real world analysis should aid in making treatment decisions. Source of Funding: NeoTract/Teleflex © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1170-e1170 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Steven Kaplan More articles by this author Daniel Rukstalis More articles by this author Expand All Advertisement Loading ...