Journal article
Population Based Comparative Effectiveness of Transurethral Resection of the Prostate and Laser Therapy for Benign Prostatic Hyperplasia
The Journal of urology, Vol.187(4), pp.1341-1345
04/2012
DOI: 10.1016/j.juro.2011.11.102
PMCID: PMC3461307
PMID: 22341267
Abstract
As the American population ages, benign prostatic hyperplasia and its associated lower urinary tract symptoms have become increasingly important causes of chronic morbidity. We assessed the comparative effectiveness of 2 common forms of surgical therapy, transurethral prostate resection and laser therapy, for benign prostatic hyperplasia.
Using patient level discharge data and revisit files from the Agency for Healthcare Research and Quality we evaluated a cohort of patients who underwent transurethral prostate resection or laser therapy for benign prostatic hyperplasia in 2005 in California. Short-term outcomes, including in hospital complications, length of stay, 30-day rehospitalization, 30-day repeat surgery and 30-day emergency room visits, were compared between the therapies by regression analysis. Long-term re-treatment, defined as the absence of secondary procedures for benign prostatic hyperplasia or complications of therapy, was assessed by survival analysis. Analysis was adjusted for medical comorbidity, race, age and insurance status.
Data on 11,645 hospital discharges showed that mean length of stay was shorter for laser therapy than for transurethral prostate resection (0.70 vs 2.03 days, p <0.0001). The 30-day repeat visit occurred in 16% of laser and 17.7% of resection cases (p = 0.0338). The 4-year re-treatment rate was 8.3% for resection and 12.8% for laser therapy (p <0.0001). After adjustment patients with resection were 37% less likely to require repeat therapy than those with laser therapy (HR 0.64, p <0.0001).
Laser procedures and transurethral prostate resection provide effective management of benign prostatic hyperplasia/lower urinary tract symptoms. Laser procedures are associated with less need for hospitalization than transurethral prostate resection but appear to involve a trade-off in long-term efficacy.
Details
- Title: Subtitle
- Population Based Comparative Effectiveness of Transurethral Resection of the Prostate and Laser Therapy for Benign Prostatic Hyperplasia
- Creators
- Seth A. Strope - Washington University in St. LouisLiu Yang - Washington University in St. LouisKenneth G. Nepple - Washington University in St. LouisGerald L. Andriole - Washington University in St. LouisPamela L. Owens - Washington University in St. Louis
- Resource Type
- Journal article
- Publication Details
- The Journal of urology, Vol.187(4), pp.1341-1345
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.juro.2011.11.102
- PMID
- 22341267
- PMCID
- PMC3461307
- ISSN
- 0022-5347
- eISSN
- 1527-3792
- Grant note
- UL1 RR024992 / Barnes Jewish Hospital Foundation/ICTS Clinical and Translational Science Research Award KL2 RR024994 / Washington University KL2 Career Development Awards Program
- Language
- English
- Date published
- 04/2012
- Academic Unit
- Urology
- Record Identifier
- 9984320857102771
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