MP3-09 COMPARISON OF SURGICAL OUTCOMES IN BENIGN PROSTATIC HYPERTROPHY MANAGEMENT USING THE NATIONAL SURGICAL QUALITY IMPROVEMENT PROGRAM

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology I1 Apr 2015MP3-09 COMPARISON OF SURGICAL OUTCOMES IN BENIGN PROSTATIC HYPERTROPHY MANAGEMENT USING THE NATIONAL SURGICAL QUALITY IMPROVEMENT PROGRAM Devin Haddad, Louis Krane, Gopal Badlani, and Majid Mirzazadeh Devin HaddadDevin Haddad More articles by this author , Louis KraneLouis Krane More articles by this author , Gopal BadlaniGopal Badlani More articles by this author , and Majid MirzazadehMajid Mirzazadeh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.112AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Increasing surgical techniques are available to provide relief of prostatic obstruction from lower urinary tract symptoms in aging gentlemen. Single institutional data concerning complication rates for rare occurrences are unlikely to be drawn out. Therefore, to compare rates of surgical complications and readmission in management of benign prostatic hyperplasia, we queried the National Surgical Quality Improvement Database (NSQIP) for perioperative adverse events following transurethral resection of the prostate (TURP), laser photo-vaporization of the prostate (PVP), and simple prostatectomy. METHODS Using the NSQIP database we identified TURP, PVP, and simple prostatectomy operations performed from 2010 to 2012 based on CPT codes 52601, 52648, and 55821, respectively. We examined multiple covariates to assess various perioperative outcomes, postoperative complications, and readmission rates. RESULTS Data were grouped by procedure: TURP (N=6653), PVP (N=3274), and simple prostatectomy (N=343) in the NSQIP database. Comparing TURP to PVP, there were no significant differences in rates of readmission, surgical site infections, pneumonia, urinary tract infection, or sepsis. However, there was a higher rate of bleeding in TURP than in PVP (2.65% vs 0.73%, p < 0.001). Comparing TURP to simple prostatectomy, there was no significant differences in rates of readmission, pneumonia, urinary tract infection, or sepsis. However, simple prostatectomy came with risk of superficial, deep, and organ surgical site infections (2.62%, 0.87%, and 0.87%, respectively). Simple prostatectomy also had a higher rate of bleeding relative to TURP (22.16% vs 2.65%, p < 0.001). Comparing PVP to simple prostatectomy, there were no significant differences in rates of readmission, pneumonia, urinary tract infection, or sepsis. However, in addition to the risk of surgical site infections, simple prostatectomy also had a higher rate of bleeding (22.16% vs 0.73%, p < 0.001). CONCLUSIONS In a review of three years of NSQIP data, TURP has a higher rate of bleeding than PVP, but there were no differences in readmission or infection rates. Simple prostatectomies had higher rates of various infections as well as bleeding. Reserving simple prostatectomy for larger sized prostates may contribute to higher bleeding rates, but prostate size is not captured in the NSQIP database and thus this possible association could not be assessed. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e22 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Devin Haddad More articles by this author Louis Krane More articles by this author Gopal Badlani More articles by this author Majid Mirzazadeh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...