PD26-07 COMPARISON OF PATIENTS UNDERGOING PHOTOVAPORIZATION OF THE PROSTATE VERSUS TRANSURETHRAL RESECTION OF THE PROSTATE

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology I1 Apr 2014PD26-07 COMPARISON OF PATIENTS UNDERGOING PHOTOVAPORIZATION OF THE PROSTATE VERSUS TRANSURETHRAL RESECTION OF THE PROSTATE Rena Malik, Chi-Hsiung Wang, Brittany Lapin, and Brian T. Helfand Rena MalikRena Malik More articles by this author , Chi-Hsiung WangChi-Hsiung Wang More articles by this author , Brittany LapinBrittany Lapin More articles by this author , and Brian T. HelfandBrian T. Helfand More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2094AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The introduction of laser therapies for the management of bladder outlet obstruction in men with benign prostatic hypertrophy (BPH) has allowed the urologist to treat patients previously thought to be poor candidates for standard transurethral resection of the prostate (TURP). We sought to compare the changing clinical characteristics of patients undergoing TURP and photovaporization of the prostate (PVP) over time. METHODS The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for men who underwent TURP and PVP from 2005-2012. Patient demographics, clinical characteristics, and 30-day postoperative outcomes were analyzed. RESULTS 12,670 men met inclusion criteria. 65% (8259) underwent TURP and 35% (4411) underwent PVP. There were significant differences in the overall demographic and clinical characteristics between groups including age, race and co-morbidities (Table 1). Those undergoing TURP were more likely to be scheduled as an emergency (3% vs. 1%, p<.01), have shorter operative times (53 vs. 56 min, p<.01), longer hospital stays (2.4 vs. 1.0 days, p<.01), more frequent blood transfusions (2.1% vs. 0.6%, p<.01), and more postoperative complications including: pneumonia (0.5% vs. 0.3%, p=0.02), septic shock (0.3% vs. 0.1%, p=0.045), and re-operation within 30 days (2.2% vs. 1.4%, p<.01). However, between 2007 and 2012, men undergoing TURP had increased functional independence (93% to 96%, p<.001), ASA Physical Class I (0.6% to 5.1%, p<.001), as well as less hypertension (68% to 59%, p<.001). In contrast, men undergoing PVP over the same time period showed an increase in co-morbidities including increased mean age (71 years to 73 years, p<.001), a higher frequency of use in emergency cases (0.8% to 2.4%, p<.01), and an increase in mean length of hospital stay (0.50 days to 1.30 days, p=.048). CONCLUSIONS Statistically significant differences in clinical characteristics of patients undergoing TURP and PVP have historically existed. However, since 2007 the use of PVP has expanded to include an older and less healthy population of men. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e761-e762 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Rena Malik More articles by this author Chi-Hsiung Wang More articles by this author Brittany Lapin More articles by this author Brian T. Helfand More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...