Impact of Minimally Invasive Benign Prostatic Hyperplasia Therapies on 30- and 90-Day Postoperative Office Encounters

Urology. 2017 Jan:99:186-191. doi: 10.1016/j.urology.2016.10.015. Epub 2016 Oct 19.

Abstract

Objective: To compare the frequency of postoperative encounters in the 30-day and 90-day postoperative periods for various bladder outlet obstruction surgical therapies.

Materials and methods: All patients who underwent transurethral resection of the prostate (TURP), GreenLight laser photovaporization of the prostate (GL-PVP) (American Medical Systems Inc.), and holmium laser enucleation of the prostate (HoLEP) from January 1, 2012 to December 31, 2014 were followed for 6 months postoperatively. All postoperative encounters such as patient calls or questions, catheter exchanges or removals, and hospital-based readmissions or emergency department visits were recorded in the electronic medical record.

Results: Two hundred and ninety-one consecutive patients underwent outlet procedures during the study period: TURP (N = 199; mean age, 71 years; mean body mass index [BMI], 28.5), HoLEP (N = 60; mean age, 68 years; mean BMI, 28.1), or GL-PVP (N = 32; mean age, 72 years; mean BMI, 29.3). No statistically significant difference was observed for age, BMI, preoperative American Urological Association symptom score, or preoperative maximum flow velocity between the 3 groups. Thirty-day postoperative encounters differed significantly between the 3 surgery types (P < .001). Specifically, there were fewer encounters within 30 days of surgery for TURP compared to both HoLEP (≥1 encounter: TURP = 48.7%, HoLEP = 66.7%; P = .006) and GL-PVP (≥1 encounter: TURP = 48.7%, GL-PVP = 93.7%; P < .001). The number of encounters within 90 days postoperatively was also significantly lower for TURP patients (P < .001).

Conclusion: TURP results in fewer postoperative encounters in both the 30-day and 90-day postoperative periods compared to HoLEP and GL-PVP. Laser prostate therapies may place increased burden on clinic staff during the 30-day and 90-day postoperative periods.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Follow-Up Studies
  • Humans
  • Incidence
  • Laser Therapy / adverse effects
  • Laser Therapy / methods
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / adverse effects*
  • Minimally Invasive Surgical Procedures / methods
  • Office Visits / trends*
  • Postoperative Complications / epidemiology*
  • Prognosis
  • Prostatic Hyperplasia / complications
  • Prostatic Hyperplasia / surgery*
  • Retrospective Studies
  • Risk Assessment / methods*
  • Time Factors
  • Transurethral Resection of Prostate / adverse effects*
  • Transurethral Resection of Prostate / methods
  • Treatment Outcome
  • United States / epidemiology
  • Urinary Bladder Neck Obstruction / etiology*
  • Urinary Bladder Neck Obstruction / surgery