PD27-11 COMPARATIVE EFFECTIVENESS OF TRANSURETHRAL RESECTION TECHNIQUES FOR BENIGN PROSTATIC HYPERPLASIA – ANALYSIS OF AN ALL PAYER INPATIENT DISCHARGE DATABASE

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You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology IV1 Apr 2017PD27-11 COMPARATIVE EFFECTIVENESS OF TRANSURETHRAL RESECTION TECHNIQUES FOR BENIGN PROSTATIC HYPERPLASIA – ANALYSIS OF AN ALL PAYER INPATIENT DISCHARGE DATABASE Christian P. Meyer, Philipp Gild, Nicolas von Landenberg, David F. Friedlander, Jairam R. Eswara, Mani Menon, Felix K.H. Chun, Margit Fisch, Maxine Sun, Benjamin L Chung Chung, Steven L Chang, and Quoc-Dien Trinh Christian P. MeyerChristian P. Meyer More articles by this author , Philipp GildPhilipp Gild More articles by this author , Nicolas von LandenbergNicolas von Landenberg More articles by this author , David F. FriedlanderDavid F. Friedlander More articles by this author , Jairam R. EswaraJairam R. Eswara More articles by this author , Mani MenonMani Menon More articles by this author , Felix K.H. ChunFelix K.H. Chun More articles by this author , Margit FischMargit Fisch More articles by this author , Maxine SunMaxine Sun More articles by this author , Benjamin L Chung ChungBenjamin L Chung Chung More articles by this author , Steven L ChangSteven L Chang More articles by this author , and Quoc-Dien TrinhQuoc-Dien Trinh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1232AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Monopolar transurethral resection (mTURP) is the conventional surgical standard of care for bladder outlet obstruction (BOO) secondary to benign prostatic enlargement (BPH). Alternatively, holmium laser techniques, bipolar TURP (bTURP) and Greenlight photovaporization of the prostate (GL-PVP) constitute modern options with favorable safety profiles. However, current literature comparing various BOO treatment modalities is limited by sample size, study design, and the absence of cost data. We sought to compare costs and complication patterns of mTURP, bTURP and GL-PVP in a large, US all-payer discharge database. METHODS Using the Premier Research Database, we identified 20,323 men 40-80 years with a diagnosis of BPH who underwent a BOO procedure between 2003-2013. Using propensity weighted logistical regression, we assessed trends and perioperative outcomes of mTURP, bTURP, and GL-PVP. RESULTS mTURP remained the most frequently performed procedure during the study period, but its utilization decreased by 20% during that time (p<0.001) (Figure 1). Whereas there were no significant differences between bTURP and mTURP with regards to OR time (p>0.99), LOS (p=0.82), and 90-day complication rates (p=0.34), GL-PVP was associated with longer OR times (+12 minutes, 95% CI: 10.25 to 13.75, p<0.001) but demonstrated a shorter LOS (OR: 0.51, 95% CI: 0.37 to 0.7, p<0.001) relative to mTURP. Both bTURP ($982, 95% CI: $509-1456, p<0.001) and GL-PVP ($1536, 95% CI: $1296-1775, p<0.001) were associated with higher 90-day direct hospital costs compared to mTURP. CONCLUSIONS We show that the volume of inpatient endoscopic management of BPH has decreased significantly over the past decade. We found only a modest perioperative safety and outcome benefit with bTURP and GL-PVP over mTURP, while both procedures were associated with higher costs. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e516 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Christian P. Meyer More articles by this author Philipp Gild More articles by this author Nicolas von Landenberg More articles by this author David F. Friedlander More articles by this author Jairam R. Eswara More articles by this author Mani Menon More articles by this author Felix K.H. Chun More articles by this author Margit Fisch More articles by this author Maxine Sun More articles by this author Benjamin L Chung Chung More articles by this author Steven L Chang More articles by this author Quoc-Dien Trinh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...