Trends and Perioperative Outcomes across Major BPH Procedures from the ACS-NSQIP 2011-2015

There are currently several different surgical options for patients with benign prostatic hyperplasia (BPH). Despite excellent postoperative results and longevity in symptom relief associated with Holmium laser enucleation of prostate (HoLEP), this procedure is not widely practiced in the United States.

Herein, we investigate trends and outcomes from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) to assess the status of HoLEP compared to other major BPH procedures.

Using ACS-NSQIP data from 2011-2015, trends, baseline characteristics and perioperative outcomes were collected for major BPH procedures: transurethral resection of prostate (TURP), TURP for regrowth, photovaporization of prostate (PVP), HoLEP and simple prostatectomy.

The most common procedure performed in every year was TURP with PVP performed about half as often, while HoLEP (4-5%) was performed about as infrequently as simple prostatectomy (3%). More African American men underwent simple prostatectomy except in 2011. INR was highest in every year for PVP. Hospital stay and transfusion rates were lowest with PVP and HoLEP. Transfusion rates for simple prostatectomy were high (16.0-25.4%). Lower rates of readmission, reoperation and urinary tract infection were seen in some years with HoLEP.

Based on data from over 35,000 major BPH procedures from the ACS-NSQIP 2011-2015, patients undergoing HoLEP had lower rates of urinary tract infection, reoperation and readmission. While transfusion rates and length of hospital stay were lowest for PVP and HoLEP, both were highest for simple prostatectomy.

Journal of endourology. 2018 Jul 24 [Epub ahead of print]

Blake Anderson, Joshua Heiman, Tim Large, James E Lingeman, Amy E Krambeck

Indiana University School of Medicine, 12250, Urology, Indianapolis, Indiana, United States ; ., Indiana University School of Medicine, 12250, Urology, Indianapolis, Indiana, United States., Indiana University School of Medicine, 12250, Urology, Indianapolis, Indiana, United States ; ., Indiana University School of Medicine, Dept. of Urology , 1801 North Senate Blvd. , Suite 220, Indianapolis, Indiana, United States , 46202 ; ., Indiana University School of Medicine, 12250, Urology, 1801 Senate Blvd. # 220, Indianapolis, Indiana, United States , 46202 ; .

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