You have accessJournal of UrologyProstate Cancer: Detection & Screening VII1 Apr 2018MP82-11 COMPARATIVE OUTCOMES AFTER 4 DIFFERENT PROSTATE BIOPSY TECHNIQUES: A FOCUS ON STANDARDIZED COMPLICATION REPORTING Cihan Demirel, Muammer Altok, John Ward, Stephen McRae, Mary Achim, and John Davis Cihan DemirelCihan Demirel More articles by this author , Muammer AltokMuammer Altok More articles by this author , John WardJohn Ward More articles by this author , Stephen McRaeStephen McRae More articles by this author , Mary AchimMary Achim More articles by this author , and John DavisJohn Davis More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2739AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Given the increased number of choices for performing a prostate biopsy, we recently reported an analysis of the cost implications, with the key findings (compared to reference transrectal ultrasound [TRUS] biopsy under local anesthesia): TRUS/IV sedation = 1.9x more expensive, transperineal (TP)/general anesthesia 2.5x, MRI-Fusion/IV sedation 2.5x, and In-Bore-MRI/IV sedation = 2.3x. In this study, we captured a representative sample of these cases to add the important layer of complication rates, as they add to the total cost. METHODS At a single tertiary care center, we retrospectively reviewed prostate biopsies from any of these modalities between 2014 and 2017. Downstream complication reporting was abstracted from hospital (combined inpatient, emergency center, clinic) and patient correspondence for the up to 90 days from procedure. Events were classified using the Clavien system. RESULTS Table 1 shows the results from 1,589 biopsies searched. Overall, TP had the highest rate of complications at 14.1% compared to <7 % for TRUS and MRI-Fusion (P <0.05). This was mostly driven by higher rates of urinary retention/catheterization. There was no statistical difference among TRUS, Fusion and In-Bore biopsies. In-Bore MRI had the lowest complication rate. Core counts were different at 24-32 for TP, 15-18 for MRI-Fusion, 12 for TRUS, and 2 for In-Bore. Urosepsis rates (with hospitalization) were 0% for TP, 0.6% for TRUS, 0.56% for MRI-fusion, and 0 for MRI In-Bore. CONCLUSIONS In addition to variant cost implications from differential use of anesthesia, number of specimens, and billing codes, complication incidence can affect overall value of a biopsy technique choice. These events can be translated in medicare allowable charges for comparison/inclusion to estimate the cost impact of complications managed in the hospital, emergency center, or clinic. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1110 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Cihan Demirel More articles by this author Muammer Altok More articles by this author John Ward More articles by this author Stephen McRae More articles by this author Mary Achim More articles by this author John Davis More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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