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    Study: Monopolar TURP utilization on the decline

    PVP associated with longer OR time but shorter length of stay than TURP

    BostonAlthough monopolar transurethral resection of the prostate (TURP) remains the standard of care for bladder outlet obstruction secondary to BPH, its utilization has decreased in recent years, according to a recent study.

    TURP is the standard of care for BPH in prostates under 80 mg, according to guidelines from the AUA and other international groups, but new approaches such as GreenLight Laser photoselective vaporization of the prostate (PVP), holmium laser ablation of the prostate (HoLAP), and holmium laser enucleation of the prostate (HoLEP) are increasingly being performed in the treatment of BPH.

    Until recently, few studies have evaluated the perioperative outcomes of these procedures in the inpatient setting, said Christian P. Meyer, MD, a urologist at the University Medical Center Hamburg-Eppendorf in Hamburg, Germany, in his presentation at the 2017 AUA annual meeting in Boston.

    Also see: PCa-specific mortality not affected by comorbidity

    For their research, Dr. Meyer and colleagues accessed the Premier Healthcare Database, an all-inpatient database representative of 20% of all U.S. hospital admissions, and looked at a cohort of approximately 140,000 patients who underwent monopolar TURP, bipolar TURP, or GreenLight Laser PVP for BPH. The timeline was from 2003 to 2013, and the research covered almost 450 hospitals across the United States. A range of inpatient settings, such as community hospitals and academic centers, was included in the study.

    The research entailed searching the charge description master file to identify specific supply codes unique to each endoscopic procedure in order to identify them appropriately. Under evaluation were 90-day postoperative complications, operating room time, hospital length of stay, and indirect hospital costs. Also factored into the analyses were patient, hospital, and surgeon characteristics, Dr. Meyer said.

    In terms of 90-day direct hospital costs, Dr. Meyer said that when bipolar and monopolar TURP were compared, bipolar TURP cost almost $1,000 more. The GreenLight Laser PVP cost almost $1,500 more than monopolar TURP.

    Next: Monopolar TURP use decreasing

    Aine Cryts
    Aine Cryts is a freelancer based in Boston. She is a frequent contributor to Managed Healthcare Executive on topics such as diabetes, ...

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