Comparison between complication rates of laser prostatectomy electrocautery transurethral resection of the prostate: A population-based study

doi:10.5489/cuaj.1790

. 2014 May;8(5-6):E419-24.

doi: 10.5489/cuaj.1790.

Comparison between complication rates of laser prostatectomy electrocautery transurethral resection of the prostate: A population-based study

Affiliations

¹ Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC; ; Department of Urology, University of Montreal Health Centre, Montreal, QC;
² Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC; ; Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; ; Department of Urology, University-Hospital Hamburg-Eppendorf, Hamburg, Germany;
³ Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC; ; Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;
⁴ Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC; ; Department of Urology, Ruhr University Bochum, Marienhospital, Herne, Germany;
⁵ Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC; ; Department of Urology, Vita-Salute, San Raffaele University, Milan, Italy;
⁶ Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC;
⁷ Department of Urology, University of Montreal Health Centre, Montreal, QC;
⁸ Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; ; Department of Urology, Section for Translational Prostate Cancer Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;
⁹ Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;
¹⁰ Department of Urology, University-Hospital Hamburg-Eppendorf, Hamburg, Germany;
¹¹ Department of Surgery, Division of Urology, Brigham and Women's Hospital/Dana-Farber Cancer Institut, Harvard Medical School, Boston, MA.

PMID: 25024796
PMCID: PMC4081257
DOI: 10.5489/cuaj.1790

Comparison between complication rates of laser prostatectomy electrocautery transurethral resection of the prostate: A population-based study

Alexandre Larouche et al. Can Urol Assoc J. 2014 May.

. 2014 May;8(5-6):E419-24.

doi: 10.5489/cuaj.1790.

Authors

Affiliations

¹ Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC; ; Department of Urology, University of Montreal Health Centre, Montreal, QC;
² Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC; ; Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; ; Department of Urology, University-Hospital Hamburg-Eppendorf, Hamburg, Germany;
³ Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC; ; Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;
⁴ Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC; ; Department of Urology, Ruhr University Bochum, Marienhospital, Herne, Germany;
⁵ Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC; ; Department of Urology, Vita-Salute, San Raffaele University, Milan, Italy;
⁶ Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC;
⁷ Department of Urology, University of Montreal Health Centre, Montreal, QC;
⁸ Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; ; Department of Urology, Section for Translational Prostate Cancer Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;
⁹ Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;
¹⁰ Department of Urology, University-Hospital Hamburg-Eppendorf, Hamburg, Germany;
¹¹ Department of Surgery, Division of Urology, Brigham and Women's Hospital/Dana-Farber Cancer Institut, Harvard Medical School, Boston, MA.

PMID: 25024796
PMCID: PMC4081257
DOI: 10.5489/cuaj.1790

Abstract

Introduction: We compare the complication rates and length of stay (LOS) of laser transurethral resection of the prostate (L-TURP) versus electrocautery transurethral resection of the prostate (E-TURP) in a population-based cohort. L-TURP has shown enhanced intraoperative safety and equivalent efficacy relative to E-TURP in several high volume centres.

Methods: Relying on the Florida Datafile as part of the Healthcare Cost and Utilization Project State Inpatient Databases (SID) between 2006 and 2008, we identified 8066 men with benign prostate hyperplasia who underwent L-TURP or E-TURP. Chi-square and Mann-Whitney tests were used to compare baseline characteristics. A multivariable linear regression model was used to analyze the effect of L-TURP versus E-TURP on complication rates and LOS.

Results: Overall complication rates did not differ significantly for L-TURP compared to E-TURP in univariable (8.8 vs. 7.4%, p = 0.1) and multivariable analyses (odds ratio [OR]: 1.06, confidence interval [CI]: 0.85-1.32, p = 0.6). Individuals undergoing E-TURP were less likely to experience a LOS in excess of 1 day (46.2 vs. 59.7%, p < 0.001). A lower risk to experience a LOS in excess of 1 day was confirmed for patients undergoing L-TURP after a multivariable linear regression model (OR: 0.37, CI: 0.23-0.58, p < 0.001), but not for a LOS in excess of 2 days (OR: 0.96, CI: 0.83-1.10, p = 0.2).

Conclusions: Patient characteristics and perioperative safety were similar for L-TURP and E-TURP patients. However, LOS patterns demonstrated a modest benefit for L-TURP compared to E-TURP patients.

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References

1. Ruszat R, Wyler S, Forster T, et al. Safety and effectiveness of photoselective vaporization of the prostate (PVP) in patients on ongoing oral anticoagulation. Eur Urol. 2007;51:1031–8. doi: 10.1016/j.eururo.2006.08.006. discussion 1038–41. - DOI - PubMed
1. Fu WJ, Hong BF, Wang XX, et al. Evaluation of greenlight photoselective vaporization of the prostate for the treatment of high-risk patients with benign prostatic hyperplasia. Asian J Androl. 2006;8:367–71. doi: 10.1111/j.1745-7262.2006.00134.x. - DOI - PubMed
1. Reich O, Bachmann A, Siebels M, et al. High power (80 W) potassium-titanyl-phosphate laser vaporization of the prostate in 66 high risk patients. J Urol. 2005;173:158–60. doi: 10.1097/01.ju.0000146631.14200.d4. - DOI - PubMed
1. Lowrance WT, Southwick A, Maschino AC, et al. Contemporary practice patterns for endoscopic surgical management of benign prostatic hyperplasia (BPH) among United States urologists. J Urol. 2012;187:2087–93. doi: 10.1016/j.juro.2012.01.061. - DOI - PMC - PubMed
1. Schroeck FR, Hollingsworth JM, Kaufman SR, et al. Population-based trends in the surgical treatment of benign prostatic hyperplasia. J Urol. 2012;188:1837–41. doi: 10.1016/j.juro.2012.07.049. - DOI - PMC - PubMed

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[1] Ruszat R, Wyler S, Forster T, et al. Safety and effectiveness of photoselective vaporization of the prostate (PVP) in patients on ongoing oral anticoagulation. Eur Urol. 2007;51:1031–8. doi: 10.1016/j.eururo.2006.08.006. discussion 1038–41. - DOI - PubMed

[2] Ruszat R, Wyler S, Forster T, et al. Safety and effectiveness of photoselective vaporization of the prostate (PVP) in patients on ongoing oral anticoagulation. Eur Urol. 2007;51:1031–8. doi: 10.1016/j.eururo.2006.08.006. discussion 1038–41. - DOI - PubMed

[3] Fu WJ, Hong BF, Wang XX, et al. Evaluation of greenlight photoselective vaporization of the prostate for the treatment of high-risk patients with benign prostatic hyperplasia. Asian J Androl. 2006;8:367–71. doi: 10.1111/j.1745-7262.2006.00134.x. - DOI - PubMed

[4] Fu WJ, Hong BF, Wang XX, et al. Evaluation of greenlight photoselective vaporization of the prostate for the treatment of high-risk patients with benign prostatic hyperplasia. Asian J Androl. 2006;8:367–71. doi: 10.1111/j.1745-7262.2006.00134.x. - DOI - PubMed

[5] Reich O, Bachmann A, Siebels M, et al. High power (80 W) potassium-titanyl-phosphate laser vaporization of the prostate in 66 high risk patients. J Urol. 2005;173:158–60. doi: 10.1097/01.ju.0000146631.14200.d4. - DOI - PubMed

[6] Reich O, Bachmann A, Siebels M, et al. High power (80 W) potassium-titanyl-phosphate laser vaporization of the prostate in 66 high risk patients. J Urol. 2005;173:158–60. doi: 10.1097/01.ju.0000146631.14200.d4. - DOI - PubMed

[7] Lowrance WT, Southwick A, Maschino AC, et al. Contemporary practice patterns for endoscopic surgical management of benign prostatic hyperplasia (BPH) among United States urologists. J Urol. 2012;187:2087–93. doi: 10.1016/j.juro.2012.01.061. - DOI - PMC - PubMed

[8] Lowrance WT, Southwick A, Maschino AC, et al. Contemporary practice patterns for endoscopic surgical management of benign prostatic hyperplasia (BPH) among United States urologists. J Urol. 2012;187:2087–93. doi: 10.1016/j.juro.2012.01.061. - DOI - PMC - PubMed

[9] Schroeck FR, Hollingsworth JM, Kaufman SR, et al. Population-based trends in the surgical treatment of benign prostatic hyperplasia. J Urol. 2012;188:1837–41. doi: 10.1016/j.juro.2012.07.049. - DOI - PMC - PubMed

[10] Schroeck FR, Hollingsworth JM, Kaufman SR, et al. Population-based trends in the surgical treatment of benign prostatic hyperplasia. J Urol. 2012;188:1837–41. doi: 10.1016/j.juro.2012.07.049. - DOI - PMC - PubMed

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Comparison between complication rates of laser prostatectomy electrocautery transurethral resection of the prostate: A population-based study

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Comparison between complication rates of laser prostatectomy electrocautery transurethral resection of the prostate: A population-based study

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