scholarly journals Cost analysis of Greenlight photoselective vaporization of the prostate compared to transurethral resection of the prostate for benign prostatic hyperplasia

2018 ◽  
Vol 12 (12) ◽  
Author(s):  
Lisa Masucci ◽  
Aysegul Erman ◽  
Murray D. Krahn ◽  
Dean Elterman

Introduction: Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland, which results in the development of lower urinary tract symptoms that can interfere with patients’ daily activities and negatively impact their quality of life. The gold standard treatment for moderate to severe BPH has been transurethral resection of the prostate (TURP), however, this procedure is associated with prolonged hospitalizations and increased complications. An alternative to TURP is Greenlight photoselective vaporization of the prostate (PVP), which is associated with better perioperative safety. The objectives of the research were to: 1) assess the cost of Greenlight PVP compared to TURP and bipolar TURP; and 2) assess the predictors of total cost. Methods: We conducted a descriptive costing study from the hospital perspective. We evaluated perioperative costs of patients who underwent each procedure from 2013–2015 at a tertiary academic medical centre. A multiple linear regression was performed to identify predictors of total cost. The variables included in regression analysis were patient age, type of procedure, Charlson Comorbidity Index, and distance to clinic. Results: A total of 202 patients received one of the three procedures over the study period. The total cost of Greenlight PVP was $3836 per patient compared to $4963 for TURP and $4978 for bipolar TURP. The linear regression showed that the Charlson Comorbidity Index and type of procedure were independent predictors of total cost. Conclusions: The procedure costs and readmission rates are lower for Greenlight PVP compared to TURP and bipolar TURP, making it a preferable option for hospitals.

e-CliniC ◽  
2017 ◽  
Vol 5 (2) ◽  
Author(s):  
Filzha Adelia ◽  
Alwin Monoarfa ◽  
Angelica Wagiu

Abstract: Benign prostatic hyperplasia (BPH) is defined as stromal cell proliferation of prostate gland which causes enlargement of the gland. It manifests as urine flow disturbance, difficult to urinate, and desire to urinate, however, the urine emission is low. In 2013, Indonesia has 9.2 million cases of BPH among men aged over 60 years. This study was aimed to obtain the profile of BPH cases at Prof. Dr. R. D. Kandou Hospital Manado in the period of January 2014 to June 2017. This was a retrospective descriptive study at Medical Record Installation of Prof. Dr. R. D. Kandou Hospital. The results showed that during that period of time, the highest percentage of cases was in 2016 (38.46%) and the most common age group was 61-70 years old (46.15%). The main complaint among the patients was difficult to urinate and the most frequently performed action was transurethral resection of prostate (TURP) (51.28%). Conclusion: In this study, BPH cases were most common at the age group 61-70 years old. Moreover, TURP was the most common action performed.Keywords: benign prostatic hyperplasia Abstrak: Benigna prostat hiperplasia (BPH) didefinisikan sebagai proliferasi dari sel stromal pada prostat, yang menyebabkan pembesaran kelenjar tersebut. Manifestasi BPH dapat berupa terganggunya aliran urin, sulit buang air kecil (BAK), dan keinginan buang air kecil namun pancaran urin lemah. Pada tahun 2013 di Indonesia terdapat 9,2juta kasus BPH, umumnya diderita laki-laki berusia di atas 60 tahun. Penelitian ini bertujuan untuk mendapatkan gambaran kasus BPH di RSUP Prof. Dr. R. D. Kandou Manado periode Januari 2014 – Juli 2017. Jenis penelitian ialah deskriptif retrospektif , yang dilakukan di Instalasi Rekam Medik RSUP Prof. Dr. R. D. Kandou Manado. Hasil penelitian menunjukkan bahwa jumlah kasus BPH tertinggi pada tahun 2016 (38,46%) dan pada kelompok usia 61-70 tahun (46,15%). Keluhan utama semua pasien ialah sulit BAK. Tindakan yang paling sering digunakan yaitu transurethral resection of prostate (TURP) (51,28%). Simpulan: Kasus BPH terutama ditemukan berusia 61-70 tahun. Tindakan yang paling sering dilakukan yaitu reseksi prostat transuretra (TURP).Kata kunci: benigna prostat hiperplasia


2021 ◽  
Vol 3 (1) ◽  
pp. 59-64
Author(s):  
Dito Dewantoro Satriawan ◽  
Diana Wijayanti ◽  
Meta Maulida Damayanti

Benign prostatic hyperplasia (BPH) merupakan istilah histopatologis, yaitu hiperplasia sel stroma dan sel epitel kelenjar prostat,dan bersifat jinak. Prevalensi BPH terjadi sekitar 70% pada pria di atas usia 60 tahun. Tujuan terapi pada pasien BPH adalah memperbaiki kualitas hidup pasien. Salah satu pilihan terapi untuk BPH yaitu transurethral resection of prostate (TURP) yang merupakan metode paling banyak digunakan untuk mengatasi pembesaran prostat. Tujuan penelitian ini adalah melihat gambaran pengaruh terapi TURP terhadap BPH pada lansia. Penelitian ini merupakan Scoping Review, yang diambil dari database PubMed, Springer Link, dan Science Direct dengan metode original research articles (observasional). Penelitian ini dinilai secara PICOS untuk ditentukan sebagai kriteria eligible pada prisma flow chart yang sesuai yaitu population (pasien BPH, lansia), intervention (terapi TURP), comparison (terapi lain), outcome (kesembuhan pasien BPH) terdapat 10.025 artikel, dan hasil uji berdasar atas PICOS sebanyak 10 artikel. Hasil analisis dan review dari 10 artikel ini, yaitu terapi TURP memiliki banyak fungsi serta manfaat untuk perbaikan kondisi pasien. Indikator tersebut dapat dinilai dari penurunan risiko perdarahan, waktu operasi, waktu irigasi kandung kemih, durasi kateterisasi, durasi rawat inap, perbaikan pada IPSS, QoL, Qmax, PVR, Na+ serum, K+ serum, kadar hematokrit, volume cairan irigasi, kadar hemoglobin, kreatinin serum, volume prostat dasar, IIEF-5, CTCAE, SHIM, MSHQ-EjD, dan ISI. Pasien BPH juga dapat mengalami risiko komplikasi intraoperatif ataupun pascaoperatif. Kesimpulan penelitian ini menunjukkan bahwa pengaruh terapi TURP terhadap BPH pada lansia mempunyai hasil yang cukup baik, efisien, dan efektif. Scoping Review: the Effect of TURP Therapy on Benign Prostatic Hyperplasia in the ElderlyBenign prostatic hyperplasia (BPH) is a histopathological term, which is hyperplasia of stromal cells and epithelial cells of the prostate gland, and is benign. The prevalence of BPH occurs in about 70% in men over the age of 60. The goal of therapy in BPH patients is to improve the patient's quality of life. One of the treatment options for BPH is the transurethral resection of prostate (TURP) which is the most widely used method to treat an enlarged prostate. The purpose of this study was to describe the effect of TURP therapy on BPH in the elderly. This research is a Scoping Review, which is taken from the PubMed, Springer Link, and Science Direct databases using the original research articles (observational) method. This study was assessed by PICOS to be determined as eligible criteria on the appropriate prism flow chart, namely population (BPH patients, the elderly), intervention (TURP therapy), comparison (other therapies), 10,025 articles of outcome (recovery of BPH patients), and test results. based on PICOS as many as 10 articles. The results of the analysis and review of these 10 articles are: TURP therapy has many functions and benefits for improving the patient's condition. These indicators can be assessed from the decreased risk of bleeding, time of operation, time of bladder irrigation, duration of catheterization, duration of hospitalization, improvement in IPSS, QoL, Qmax, PVR, serum Na +, serum K +, levels of hematocrit, volume of irrigation fluid, hemoglobin levels, serum creatinine, baseline prostate volume, IIEF-5, CTCAE, SHIM, MSHQ-EjD, and ISI. Patients with BPH may also be at risk of intraoperative or postoperative complications. The conclusion of this study shows that the effect of TURP therapy on BPH in the elderly has good, efficient and effective results.


Author(s):  
Rakhimov S.A. ◽  
Feofilov I.V. ◽  
Arbuzov I.A.

Benign prostatic hyperplasia is one of the most common diseases in urological practice. The classical method of surgical treatment of benign prostatic hyperplasia is transurethral resection of the prostate gland. However, this operation is accompanied by a fairly large number of postoperative complications and is not recommended for patients with a large prostate volume, with a high cardiovascular risk, and receiving anticoagulant therapy. In recent years, the medical community has been paying close attention to laser technologies. The article provides an overview of the literature on laser methods for the treatment of benign prostatic hyperplasia. Modern laser systems are considered: holmium, thulium, diode, «green» lasers. The advantages and disadvantages of each technique are described. The results of studies of the efficacy and safety of laser surgical methods for the treatment of benign prostatic hyperplasia and their influence on the indicators of urodynamics, symptoms of the disease, and the quality of life of patients are presented. Based on the analysis of scientific literature sources, it was concluded that laser methods of surgical treatment of benign prostatic hyperplasia are clinically effective and safe. Compared with transurethral resection of the prostate, laser technologies can shorten the period of hospitalization and catheterization of patients, have a low number of complications, provide good hemostasis, and can be used regardless of the volume of the gland in patients with concomitant diseases who are taking anticoagulants. Laser methods of surgical treatment of benign prostatic hyperplasia are currently a full-fledged worthy alternative to transurethral resection of the prostate gland. Among the disadvantages of using laser systems are the duration of the operation and the need to train specialists in the technique of surgical intervention.


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