P052 EARLY OPERATIVE OUTCOMES OF ENHANCED-VIEW TOTALLY EXTRA PERITONEAL REPAIR(ETEP) FOR VENTRAL HERNIAS

Abstract Aim Early operative outcomes of enhanced-view totally extraperitoneal repair (eTEP) for ventral hernias Material and Methods We have retrospectively analysed the date of 41 patients who underwent an eTEP procedure on between November 2018 and April 2021 by a single surgeon and monitored until May 2021. Results During the study period, 29 endoscopic transversus abdominis muscle release and 12 endoscopic Rives-Stoppa techniques were performed to repair incisional (30), umbilical (6), epigastric (3), and spigelian, and parastomal hernias occurred in 1 patient each. The mean age was 68.0 years, mean BMI was 26.4 kg/m2. The hernial orifice centers were as follows: M2 in 7, M3 in 23, M4 in 5, L2 in 4, L4 in 1, and M2 and L2 (2 orifices) in 1 patient. Nine cases of large incisional hernia (width ≥10cm) were included. An average mesh area of 624cm2 was used for an average defect area of 57cm2. Mean operative time, blood loss, and length of hospital stay were 278 min, 5 ml, 6 days, respectively. Only one case was converted to an open operation due to presence of severe adhesions. Postoperative complication consisted of hematoma (n = 1) and a small bowel obstruction due to a tear of the posterior sheath (n = 1). There was no hernia recurrence at mean follow-up of 448 days. No patient reported significant pain at the surgical site at the first postoperative follow up. Conclusions Judging from our short-term results, eTEP approach for ventral hernias can be an attractive option for selected cases.

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P053 COMPARISON OF CLINICAL OUTCOMES BETWEEN INTRAPERITONEAL ONLAY MESH REPAIR (IPOM PLUS) AND ENHANCED-VIEW TOTALLY EXTRAPERITONEAL REPAIR (ETEP) FOR VENTRAL HERNIAS

British Journal of Surgery ◽

10.1093/bjs/znab395.049 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

Hiroshi Hirukawa

Keyword(s):

Ventral Hernia ◽

Mesh Repair ◽

Transversus Abdominis ◽

Incisional Hernias ◽

Totally Extraperitoneal ◽

Onlay Mesh ◽

The Mean ◽

Totally Extraperitoneal Repair ◽

Hernia Size ◽

Ventral Hernias

Abstract Aim We have been performing intraperitoneal on lay mesh repair (IPOM plus) as the standard laparoscopic procedure for ventral hernia in our department. We introduced enhanced-view totally extraperitoneal repair (eTEP) for ventral hernia repair in 2018, and have performed 31 cases so far. We compared the outcomes of IPOM Plus and eTEP at our institution. Material and Methods Ventral hernia cases who underwent surgery at our department between 2018 and 2020 were included in the study. The postoperative outcomes and complications of the IPOM Plus and eTEP groups were evaluated retrospectively. Results There were 12 cases of IPOM plus, and all were incisional hernias. There were 31 cases of eTEP, including 7 cases of primary hernias and 24 cases of incisional hernias. Transversus abdominis muscle release (TAR) was added in 24 cases. The mean hernia size was 6.6 x 7.9 cm with IPOM Plus and 8.0 x 10.1 cm with eTEP, and the average meshes size was 15.5 x 22.0 cm and 20.3 x 23.6 cm, respectively. The mean postoperative hospital stay was 7.8 days and 5 days. Postoperative complications included 1 case of mesh bulging and 1 case of recurrence in the IPOM Plus group, 1 case of seroma and 1 case of intestinal obstruction in the eTEP. Conclusions The surgical outcomes for ventral hernias up to 8 cm wide were similar for IPOM Plus and eTEP. The eTEP can insert a larger mesh and may be useful for wider hernias (>8cm).

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Hybrid approach to ventral wall hernia repair: a single-institution cohort study

European Surgery ◽

10.1007/s10353-020-00671-y ◽

2020 ◽

Author(s):

Sara Jamel ◽

Sherif Mohamad Hakky ◽

Karina Tukanova ◽

Sarah Huf ◽

Sheraz Markar ◽

...

Keyword(s):

Chronic Pain ◽

Cohort Study ◽

Hernia Repair ◽

Hybrid Approach ◽

Length Of Hospital Stay ◽

Patient Reported Outcome Measures ◽

Defect Size ◽

Hybrid Technique ◽

Patient Reported

Summary Background Ventral hernias pose a substantial challenge for surgeons. Even though minimally invasive surgery and hernia repair have evolved rapidly, there is no standardised method that has been widely accepted as standard of practice. Hybrid ventral hernia repair (HVR) is an alternative surgical approach, which has not been adopted widely to date. It combines laparoscopic mesh insertion with closure of the hernia defect. The aim of this retrospective cohort study is to evaluate short- and long-term outcomes in patients undergoing HVR. Methods Between October 2012 and June 2016, 56 HVRs were performed at St Mary’s Hospital, Imperial College London. The medical records of these patients were reviewed retrospectively for demographics, comorbidities, previous surgeries, operative technique, complications and recurrences over a 3-year follow-up. Results HVRs were performed by four surgeons. Mean age was 48 years with a mean body mass index (BMI) of 32.8 kg/m2. 71.4% had incisional hernias and 28.6% had primary hernias. The number of hernia defects ranged from 1 to 4, with average defect size 42.9 cm2 (range 8–200 cm2). Adhesiolysis was performed in 66.1% of patients. Recurrence occurred in 2 patients (3.6%), 16.1% of patients developed postoperative seroma, 0.3% had respiratory complications, 0.3% had paralytic ileus and 0.2% had urinary retention. Only 2 patients required epidural postoperatively, both had a defect size of 150.0 cm2. There were no reoperations within 90 days. Mean length of hospital stay was 2 days (1–10 days). Over the follow-up period, 2 patients (3.6%) developed chronic pain. Conclusion The hybrid technique is safe and feasible, and has important benefits including low rates of seroma formation, chronic pain and hernia recurrence. Future investigations may include randomised controlled trials to evaluate the benefits of VHR, with careful assessment of patient-reported outcome measures including quality of life and postoperative pain.

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A Prospective, Single Arm, Multi-Center Study Evaluating the Clinical Outcomes of Ventral Hernias Treated with OviTex® 1S Permanent Reinforced Tissue Matrix: The BRAVO Study 12-Month Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10214998 ◽

2021 ◽

Vol 10 (21) ◽

pp. 4998

Author(s):

George DeNoto ◽

Eugene P. Ceppa ◽

Salvatore J. Pacella ◽

Michael Sawyer ◽

Geoffrey Slayden ◽

...

Keyword(s):

Hernia Repair ◽

Ventral Hernia ◽

Ventral Hernia Repair ◽

Hernia Recurrence ◽

Patient Reported ◽

Multi Center Study ◽

Tissue Matrix ◽

Ventral Hernias ◽

Center Study

Background: Conflicting results from previous studies have led to dissent over whether surgical mesh is safe and effective in ventral hernia repair. A newer class of mesh known as a reinforced tissue matrix, combining a biologic scaffold and minimal polymer reinforcement, offers promise in reducing inflammatory response and increasing abdominal wall support. This study sought to assess the clinical utility of a reinforced tissue matrix (OviTex) in ventral hernia repair 12 months after implantation. Methods: This is a prospective, single-arm, multi-center study to evaluate the clinical performance of OviTex® 1S Permanent (OviTex) in the repair of primary or recurrent ventral hernias (VH) in consecutive patients (ClinicalTrials.gov/NCT03074474). The rate of surgical site occurrences (SSOs) was evaluated 90 days post-surgery as the primary endpoint. Hernia recurrence and the incidence of postoperative events were evaluated between three and 12 months as secondary endpoints. The incidence of other complications and patient-reported outcomes were also recorded. Results: Ninety-two (92) patients were enrolled in the study, of whom seventy-six (76) reached the 12-month follow-up. All patients were at least 18 years of age with a BMI of <40 kg/m2. Hernia defects were <20 × 20 cm, classified as class I–III according to the CDC wound classification system. Of the 76 patients who reached 12-month follow-up, twenty-six (34%) had previous VH repairs and thirteen (17%) had previous surgical infection. Sixty (79%) had factors known to increase the risk of recurrence. Twenty patients (26%) experienced SSOs, with ten (13%) requiring procedural intervention. Two of the 75 patients (2.7%) experienced a recurrence. Conclusions: The low rate of hernia recurrence and SSOs requiring intervention illustrates the potential that reinforced tissue matrices, and OviTex 1S, in particular, have to improve outcomes in VH repairs. Follow-up to 24 months is ongoing.

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Longitudinal Clinical and Patient-Reported Outcomes After Transversus Abdominis Release for Complex Hernia Repair With a Review of the Literature

The American Surgeon ◽

10.1177/00031348211038580 ◽

2021 ◽

pp. 000313482110385

Author(s):

Adrienne N. Christopher ◽

Martin P. Morris ◽

Louis-Xavier Barrette ◽

Viren Patel ◽

Robyn B. Broach ◽

...

Keyword(s):

Hernia Repair ◽

Patient Reported Outcomes ◽

Abdominal Wall Reconstruction ◽

Transversus Abdominis ◽

Fascial Closure ◽

Review Of The Literature ◽

Transversus Abdominis Release ◽

Patient Reported ◽

Disease Specific

Purpose Posterior component separation with transversus abdominis release (TAR) enables medial myofascial flap advancement in complex abdominal wall reconstruction. Here, we add to a growing body of literature on TAR by assessing longitudinal clinical and patient-reported outcomes (PROs) after complex ventral hernia repair (VHR) with TAR. Methods Adult patients undergoing VHR with TAR between 10/15/2015 and 1/15/2020 were retrospectively identified. Patients with parastomal hernias and <12 months of follow-up were excluded. Clinical outcomes and PROs were assessed. Results Fifty-six patients were included with a median age and body mass index of 60 and 30.8 kg/m2, respectively. The average hernia defect was 384 cm2 [IQR 205-471], and all patients had retromuscular mesh placed. The most common complications were delayed healing (19.6%) and seroma (14.3%). There were no cases of mesh infection or explantation. Previous hernia repair and concurrent panniculectomy were risk factors for developing complications ( P < .05). One patient (1.8%) recurred at a median follow-up of 25.2 months [IQR 18.2-42.4]. Significant improvement in disease-specific PROs was maintained throughout the follow-up period (before to after P < .05). Conclusion Transversus abdominis release is a safe and efficacious technique to achieve fascial closure and retromuscular mesh in the repair of complex hernia defects.

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Repair of Small and Medium Size Umbilical Hernias with the “Proceed Ventral Patch” in the Preperitoneal Position

The American Surgeon ◽

10.1177/000313481508101127 ◽

2015 ◽

Vol 81 (11) ◽

pp. 1144-1148 ◽

Cited By ~ 4

Author(s):

Nikolaos Zarmpis ◽

Dirk Wassenberg ◽

Peter C. Ambe

Keyword(s):

Length Of Hospital Stay ◽

Preperitoneal Space ◽

Medium Size ◽

Care Hospital ◽

Median Length ◽

Primary Care Hospital ◽

Duration Of Surgery ◽

Male Patients ◽

Ventral Hernias

Small- and medium-sized ventral hernias including umbilical hernias can be repaired using prosthetic patches placed in the peritoneum. However, bowel-associated complications secondary to intraperitoneally placed hernia patches have been reported. Herein, we report the outcome of small and medium umbilical hernia closure with prosthetic hernia patches in the preperitoneal space. Prospectively collected data of patients undergoing repair of small- and medium-sized umbilical hernias with the proceed ventral patch in a primary care hospital in Germany was retrospectively analyzed. A total of 39 cases, including 11 female and 28 male patients, were managed with prosthetic patches in the preperitoneal position. Small-sized patches were implantated in 16 cases, whereas medium-sized patches were used in 23 cases. The median duration of surgery was 40 minutes. The median length of hospital stay was four days. Four minor complications were recorded (10.3%) and the rate of recurrence was 2.6 per cent within a follow-up period of up to 30 months. Small and medium size umbilical hernias can be effectively closed with prosthetic patches placed in the preperitoneal space without risk of serious bowel associated complications.

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Reading the Future

Foot & Ankle Orthopaedics ◽

10.1177/2473011417s000273 ◽

2017 ◽

Vol 2 (3) ◽

pp. 2473011417S0002

Author(s):

Ashlee MacDonald ◽

Jeff Houck ◽

Judith Baumhauer

Keyword(s):

Hallux Valgus ◽

Area Under The Curve ◽

Roc Curves ◽

Measurement Information ◽

Foot And Ankle ◽

Assessment Scores ◽

Operative Outcomes ◽

Patient Reported ◽

D Values

Category: Bunion, Midfoot/Forefoot Introduction/Purpose: Hallux valgus is a common condition of the foot with 4.4 million patients seeking care yearly for this condition. A previous study suggested specific pre-operative cut-off scores based on Patient Reported Outcomes Measurement Information System (PROMIS) physical function (PF), pain interference (PI), and depression (D) values could predict post-operative outcomes in foot and ankle surgery. Though hallux valgus correction, among other procedures, were identified as one of the most common surgeries in the previous study, specific conditions were not considered separately. The purpose of this study was to evaluate the validity of applying a published comprehensive pre-surgical PROMIS profile of PF, PI and D to patients undergoing bunionectomy surgery. Methods: PROMIS scores were prospectively obtained from patients evaluated in a specialty foot and ankle clinic between February 2015 and November 2016. Using ICD-9/10 and CPT codes, a total of 65 patients with hallux valgus who underwent a bunionectomy by a single surgeon were identified. Those with less than two-month follow-up, multiple procedures during the follow-up period, and incomplete PROMIS assessment scores were excluded, resulting in 42 patients. Using pre-operative scores and scores at the last follow-up visit, minimally clinically important differences (MCID), receiver operating characteristic (ROC) curves, and area under the curve (AUC) were obtained to determine if pre-operative PROMIS scores predicted achieving MCID with 95% specificity or failing to achieve a MCID with 95% sensitivity. New cut-off values were then compared to the previous study. Results: The AUC for PF (p=0.01) and Mood (p=0.03) were significant. However, PI AUC was not significant (p=0.14). The PF cut off for 95% specificity of exceeding MCID was 39.6 and 50.2 for 95% sensitivity for failing to achieve MCID. The D cut off for 95% specificity of exceeding MCID was 39.4 and 58.1 for 95% sensitivity for failing to achieve MCID. Patients below the 50.2 threshold (n=27) had significantly greater improvements on PF (2.3 95% CI 0.5 to 4.3) and PI (-3.8 95% CI -6.9 to -0.7) but not D. Patients above the 50.2 cut off (n=15) were significantly worse on PF (-7.3 95% CI -12.0 to -2.7) at this short follow up and were statistically unchanged on PI and D. Conclusion: This data confirms that pre-surgical PROMIS PF and Depression scores are significant post-surgical predictors. However, cut-off scores for 95% sensitivity/specificity were one standard deviation higher for PROMIS PF (>50.2 versus previous study >42) and similar for Depression (<39.4 versus previous study <41.5) as compared to all foot and ankle surgeries. Patients meeting the new cut-off (>50.2) experienced significantly better outcomes on all PROMIS scales and patients not meeting the cut- off (~30%) were significantly worse. Although longer term follow-up is desirable, this short term follow up suggests a significant clinical impact of using PROMIS scores for pre-surgical decisions.

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Ankle fractures: What role does level of insurance play in recovery and outcomes?

Trauma ◽

10.1177/1460408618809018 ◽

2018 ◽

Vol 22 (1) ◽

pp. 32-39 ◽

Cited By ~ 1

Author(s):

Wajeeh Bakhsh ◽

Sean Childs ◽

Kyle Judd ◽

Gillian Soles ◽

Catherine Humphrey ◽

...

Keyword(s):

Patient Reported Outcomes ◽

Insurance Coverage ◽

Ankle Fractures ◽

Complication Rates ◽

Fracture Characteristics ◽

Operative Outcomes ◽

Pain Scores ◽

Patient Reported ◽

Perioperative Complication

Introduction A number of factors including socioeconomic status have been correlated with post-operative outcomes in orthopedic trauma. The objective of this study is to compare post-operative courses and patient-reported outcomes following operatively managed ankle fractures taking into account a patient's level of insurance coverage. Methods A retrospective cohort study was performed at a single level I trauma center. Patients were identified by billing code for operative intervention of ankle fractures (OTA 44) from January 2014 to January 2015. Study outcomes included narcotic refills, compliance with follow-up visits, visual analog scale (VAS) pain scores, Patient-Reported Outcomes Measurement Information System (PROMIS) survey data, and perioperative complication rates. Statistical analysis included mean comparison between insurance groups and multivariate regression modeling. Results From January 2014 to January 2015, 209 patients met the inclusion criteria (45 patients under/uninsured vs. 164 fully insured). No differences were found amongst demographic data or fracture characteristics. The underinsured group had a higher average number of narcotic prescriptions (2.6 refills vs. 1.5 refills, p < 0.05). The underinsured group also demonstrated a significantly greater number of missed post-operative clinic visits (0.8 vs. 0.3 visits p < 0.05); the total number of post-operative visits were similar (6.4 vs. 6.9, p = 0.38). At one-year follow-up, the underinsured group had higher pain scores (VAS 3.8 vs. 2.1, p < 0.05), and significantly worse PROMIS scores with respect to mood (54 vs. 49.1, p < 0.05), pain (59.6 vs. 55.5, p < 0.05), and functional outcomes (38 vs. 44.7, p < 0.05). There was no difference in perioperative complication rates. Multivariate regression modeling found insurance (p < 0.05), age (p < 0.05), and smoking (p < 0.05) to be significant determinants of post-operative outcomes. Conclusion Despite similar demographic and fracture characteristics, patients with decreased insurance coverage demonstrated higher narcotic requirements and missed more appointments. They had worse subjective and objective outcomes. As physician reimbursement becomes increasingly dependent on outcomes, further understanding of the psychosocial factors of this subset of patients is needed to establish realistic expectations and identify avenues for further intervention.

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P085 CLINICAL AND LONGITUDINAL PATIENT REPORTED OUTCOMES AFTER TRANSVERSUS ABDOMINIS RELEASE: A SINGLE SURGEON EXPERIENCE

British Journal of Surgery ◽

10.1093/bjs/znab395.079 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

Adrienne Christopher ◽

Martin Morris ◽

Louis-Xavier Barrette ◽

Robyn Broach ◽

John Fischer

Keyword(s):

Hernia Repair ◽

Patient Reported Outcomes ◽

Transversus Abdominis ◽

Abdominal Hernia ◽

Transversus Abdominis Release ◽

Surgeon Experience ◽

Patient Reported ◽

Related Quality

Abstract Aim Posterior component separation with transversus abdominis release (TAR) is a novel complex abdominal wall repair technique that maximizes medial myofascial flap advancement in a vascularized, pre-peritoneal plane. Here, we add to a growing body of literature on this technique by assessing longitudinal clinical and patient reported outcomes (PROs) after ventral hernia repair (VHR) with TAR. Material and Methods Adult patients undergoing VHR with TAR between 10/1/2015 and 01/15/2020 by a single surgeon were retrospectively identified. Patients with parastomal hernias and <12 months of follow-up were excluded. Clinical outcomes and PROs using the Abdominal Hernia Questionnaire (AQH) and Hernia Related Quality of Life Survey (HerQLes) were assessed. Results 57 patients were included with a median age and body mass index of 60 and 30.6 kg/m2, respectively. The average hernia defect was 384 cm2 [IQR 205-471], and all patients had retro-muscular mesh placed. The most common complications were delayed healing (19.3%) and seroma (14.0%). One patient required return to the OR for management of a complication and there were no cases of mesh infection or explantation. Previous hernia repair and concurrent panniculectomy were risk factors for developing any complication (p < 0.05). One patient (1.8%) recurred at a median follow-up of 25.7 months [IQR 18.2-42.1]. Significant improvement in disease-specific PROs was observed and maintained throughout the follow-up period (pre to post p < 0.05). Conclusions Longitudinal clinical and patient-reported outcomes after VHR with TAR are limited. We conclude that TAR is a safe and efficacious adjunct in the repair of complex hernia defects.

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Functional Outcomes and Return To Sport With Extraarticular Plating Of Lisfranc Injuries In Athletes

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119s00388 ◽

2019 ◽

Vol 7 (7_suppl5) ◽

pp. 2325967119S0038

Author(s):

Stephanie M. Jones ◽

Arthur R. McDowell ◽

Samuel O. Ewalefo ◽

Monique C. Chambers ◽

Dwayne Carney ◽

...

Keyword(s):

Patient Reported Outcomes ◽

Locking Plate ◽

Statistical Significance ◽

P Value ◽

Dorsal Plate ◽

Lisfranc Joint ◽

Operative Outcomes ◽

Patient Reported ◽

Lisfranc Injuries

Objectives: Lisfranc injuries are increasingly common among athletes. Tarsometatarsal joint injuries often damage the articular cartilage and increase predisposition for post-traumatic arthritis and functional deformity of the midfoot. Injury-related morbidity in athletes has substantial consequences such as decreased performance and earlier retirement from sports. While open reduction and internal fixation (ORIF) has been established as the standard of care for unstable Lisfranc injuries, there is currently no consensus regarding the optimal technique for stabilization. Extra-articular fixation has been described as a reasonable technique for Lisfranc joint stabilization due to avoidance of iatrogenic articular disruption and subsequent morbidity. The purpose of this study was to assess the pre- and post-operative patient-reported outcomes of athletes with Lisfranc injuries following ORIF using an extra-articular dorsal locking plate. Methods: Following Institutional Review Board (IRB) approval, data was collected prospectively using an institution-based patient-reported outcomes registry. The registry was queried for patients who had undergone open treatment for tarsometatarsal dislocation (CPT 28615) between April 2015 and August 2018. Medical records were reviewed for the following criteria: athlete, 15 - 45 years of age, Lisfranc injury, ORIF, extra-articular dorsal locking plate, and completion of both pre- and post-operative outcomes surveys. 10 athletes were identified. The surveys used were as follows: VAPS, PASS, PROMIS-M, PROMIS-P, SF12-M, SF12-P, FAAM-ADL and FAAM-Sports. A comparison of pre- and post-operative outcomes was performed using paired t-tests. Statistical significance was defined as a p-value <0.05. Results: 10 athletes (5 male, 5 female) with an average age of 18.2 years were analyzed. Sports included football, gymnastics, soccer, hockey, and basketball. Competition levels included high school and college. All athletes had scheduled hardware removal between 3 - 5 months (average 4.4 months) after the initial ORIF. The FAAM-ADL scores (Δ42.49, p <0.0174) improved significantly at 6-months follow-up. The improvement of FAAM-ADL scores continued to trend positively for up to 1-year post-operatively; however, there was insufficient data to analyze for significance. There was no statistical significance observed between pre- and post-operative VAPS, PASS, PROMIS-M, PROMIS-P, SF12-M, SF12-P and FAAM-Sports scores at 6-months follow-up. 100% of athletes returned to sport at an average of 6 months. Conclusion: In athletes, extra-articular dorsal plate fixation of the Lisfranc joint demonstrates improvement in post-operative patient reports of function. Broad-statistical significance across all patient-reported measures was likely limited due to the number of participants. Patient-reported outcomes may serve as a guide to assess athlete progress during the post-operative period. Further studies are needed to compare the long-term outcomes of Lisfranc injuries in athletes following various methods of fixation.

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Outcome of Photoselective Vaporization of the Prostate with the GreenLight-XPS 180 Watt System Compared to Transurethral Resection of the Prostate

Journal of Clinical Medicine ◽

10.3390/jcm8071004 ◽

2019 ◽

Vol 8 (7) ◽

pp. 1004 ◽

Cited By ~ 3

Author(s):

Maximilian Reimann ◽

Nikita Fishman ◽

Isabel Lichy ◽

Laura Wiemer ◽

Sebastian Hofbauer ◽

...

Keyword(s):

Hospital Stay ◽

Transurethral Resection ◽

Length Of Hospital Stay ◽

Patient Reported Outcome ◽

Treatment Modalities ◽

Complication Rates ◽

Significant Difference ◽

Patient Reported ◽

Photoselective Vaporization

The aim of this paper was to compare the perioperative and postoperative results of photoselective vaporization of the prostate with the GreenLight-XPS 180 Watt System (PVP) and transurethral resection of the prostate (TURP). This retrospective study included 140 men who underwent PVP and 114 men who underwent TURP for symptomatic benign prostate enlargement (BPE) between June 2010 and February 2015. The primary outcome measures were the patient reported outcome, operative results, International Prostate Symptom Score-Quality of Life (IPSS-QoL), complication rates, catheterization time, and length of hospital stay. The median follow-up times were 27 months (range 14–44) for the PVP group and 36 months (range 25–47) for the TURP group. The patient characteristics were well balanced in both groups with a median age of 71 years (PVP group) vs. 70 years (TURP group) and a comparable prostate volume (median 50 mL in the PVP group vs. 45 mL in the TURP group). The IPSS-QoL was significantly higher in the PVP group than in the TURP group (median 22 + 4; range 16–27 + 3−5 vs. median 19 + 3; range 15−23 + 3−4; p = 0.02). Men undergoing PVP were more likely to be on anticoagulants (PVP group n = 23; 16% vs. TURP group n = 2; 2%, p < 0.001). The median operation time (OT; min) for both procedures was comparable with 68 min (PVP group; range 53–91) vs. 67 min (TURP group; range 46–85). The rate of severe intraoperative bleeding was significantly lower in the PVP group than in the TURP group (n = 7; 5% vs. n = 16; 14%; p = 0.01). The postoperative catheterization time and length of hospital stay was significantly lower in the PVP group (median 1–2 days; range 1–4) vs. the TURP group (median 2–4 days; range 2–5; both p < 0.001). Complication rates (Clavien-Dindo classification ≥III) based on the follow-up data showed no statistically significant difference between the PVP group and the TURP group (n = 6; 4% vs. n = 6; 5%; p = 0.28). The IPSS on follow-up showed an equivalent reduction in symptoms for both treatment modalities (IPSS-QoL of 5 + 1; range 2–11 + 0−2 for both). There were no differences concerning urge (PVP group n = 3; 2% vs. TURP group n = 3; 3%; p = 0.90) and men were similarly satisfied with the postoperative outcome (PVP group 92% vs. TURP group 87%; p = 0.43). The PVP group was associated with a shorter hospitalization time and showed a reduced risk of bleeding, despite patients remaining on anticoagulants, without increasing the overall operative time. There was no difference in the patient reported outcome for both procedures.

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