Perioperative and economic analysis of surgical treatments for benign prostatic hyperplasia: A study of the French committee on LUT.

To evaluate perioperative cost related to surgical treatments of benign prostatic obstruction (BPO): photoselective vaporization of the prostate (pvp), holmium/thullium laser enucleation (HoLEP/ThuLEP), transurethral resection of the prostate (TURP) and open prostatectomy (OP).

We retrospectively collected data from 237 patients who consecutively underwent a surgical treatment for BPH between January 2012 and June 2013 at nine institutions in France. An economic simulation model was constructed to estimate the cost of hospitalization related to surgical procedure from the hospital perspective and a cost minimization analysis was performed.

TURP, OP, HoLEP/ThuLEP and PVP were performed in 99 (42%), 23 (10%), 64 (27%) and 51 (21%) patients, respectively. For men with prostate size<80mL: mean operative time was shorter with mTURP and PVP than HoLEP/thuLEP (P<0.001); Mean postoperative length of stay were 1.9, 3 vs. 3.4 days, for HoLEP/Thulep, PVP and TURP respectively (P=0.006); Costs of first hospitalization were comparable between HoLEP/ThuLEP and TURP but higher with PVP (P<0.001). For men with prostate size≥80mL: Compared to PVP and HoLEP/ThuLEP, OP was associated with shorter operative time (P<0.001) but longer length of stay (2.4, 4.2 vs. 7.8 days, respectively, P<0.0001); Costs of first hospitalization were significantly higher with OP than HoLEP/ThuLEP or PVP (P<0.001).

PVP and HoLEP/ThuLEP were associated with a shorter LOS than TURP and OP. This benefit suggests these procedures could be more cost effective than OP, but still not cheaper alternatives to TURP.


Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2017 May 08 [Epub]

R Mathieu, S Lebdai, J N Cornu, A Benchikh, A R Azzouzi, N B Delongchamps, O Dumonceau, A Faix, M Fourmarier, O Haillot, B Lukacs, V Misrai, A de La Taille, G Robert, A Descazeaud

Service d'urologie, hôpital Pontchaillou, CHU de Rennes, 2, rue Henri-Le-Guillou, 35000 Rennes, France. Electronic address: ., Service d'urologie, CHU d'Angers, 49933 Angers, France., Department of Urology, Rouen University Hospital, 76031 Rouen cedex, France., Service d'urologie, hôpital Bichat-Claude-Bernard, groupe des hôpitaux universitaires Paris-Nord-Val-de-Seine, université Denis-Diderot, Paris-VII, 75018 Paris, France., Service d'urologie, CHU Cochin, Assistance publique-Hôpitaux de Paris, 75014 Paris, France., Service d'urologie, Clinique Turin, 9, rue de Turin, 75008 Paris, France., Clinique mutualiste Beausoleil, 34070 Montpellier, France., Service d'urologie, centre hospitalier Aix-en-Provence, 13616 Aix-en-Provence, France., Service d'urologie, CHU de Tours, 37044 Tours, France., Service d'urologie, hôpital Tenon, université Paris VI, Assistance publique-Hôpitaux de Paris, 75020 Paris, France., Service d'urologie, clinique Pasteur, 40, avenue de Lombez, 31300 Toulouse, France., Service d'urologie, CHU Mondor, Assistance publique-Hôpitaux de Paris, 75000 Paris, France., Service d'urologie, CHU de Bordeaux, université de Bordeaux, 33000 Bordeaux, France., Service de chirurgie urologique, hôpital Dupuytren, CHU de Limoges, 2, avenue Martin-Luther-King, 87042 Limoges, France.