PD25-07 COMPARISON OF 30-DAY COSTS AND PERIOPERATIVE OUTCOMES AMONG PATIENTS UNDERGOING ROBOT ASSISTED SIMPLE PROSTATECTOMY (RASP) VERSUS HOLMIUM LASER ENUCLEATION OF THE PROSTATE (HOLEP)

Abstract

You have accessJournal of UrologyHealth Services Research: Value of Care: Cost and Outcomes Measures II (PD25)1 Sep 2021PD25-07 COMPARISON OF 30-DAY COSTS AND PERIOPERATIVE OUTCOMES AMONG PATIENTS UNDERGOING ROBOT ASSISTED SIMPLE PROSTATECTOMY (RASP) VERSUS HOLMIUM LASER ENUCLEATION OF THE PROSTATE (HOLEP) William French, Davis Viprakasit, and David Friedlander William FrenchWilliam French More articles by this author , Davis ViprakasitDavis Viprakasit More articles by this author , and David FriedlanderDavid Friedlander More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002018.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Simple prostatectomy and laser enucleation are surgical treatment options for men with symptomatic benign prostatic hyperplasia (BPH) with large prostates (>80 grams). The decision between the two modalities is often dependent on surgeon preference/experience and equipment availability. As the use of minimally invasive techniques, such as robotic assisted simple prostatectomy (RASP), has increased for the treatment of large gland BPH, studies comparing the outcomes and costs of these modalities in a contemporary cohort are lacking. METHODS: All-payer data from the 2016 Healthcare Cost and Utilization Project (HCUP) State Databases from Florida (FL) and New York (NY) were used to identify a cohort of adult patients who underwent either a RASP or Holmium laser enucleation of the prostate (HoLEP) for BPH. Patient demographics, facility characteristics, and procedural information were collected, and index costs were calculated. Multivariable logistic and gamma generalized linear regression were utilized to identify predictors of surgery type, predictors of 30-day readmission, and index costs. RESULTS: Of the 799 patients in the cohort, 396 (50%) underwent RASP. Predictors of undergoing RASP included higher Elixhauser Comorbidity score (OR 2.88, CI 1.42-5.83, p<0.003), uninsured status (OR 5.29, CI 0.99–28.29, p<0.05), or living in a micropolitan (OR 4.29, CI 1.58–11.65, p<0.004) or rural area (OR 2.98, CI 1.09–8.11, p<0.03). Higher Elixhauser Comorbidity score (≥ 3, OR 9.19, CI 4.46–18.93, p<0.001) and increased post-operative length of stay (OR 1.90, CI 1.29–2.81, p<0.001) were predictive of 30-day revisit. RASP was significantly cheaper than HoLEP with an average difference of $1,149 (p<0.001). CONCLUSIONS: RASP is performed as frequently as HoLEP and appears to be more frequently performed in non-metropolitan areas among uninsured patients with more comorbidities. RASP was significantly cheaper than HoLEP on average. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e434-e434 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information William French More articles by this author Davis Viprakasit More articles by this author David Friedlander More articles by this author Expand All Advertisement Loading ...