A Cost–Benefit Analysis of Bipolar TURP for the Treatment of Bladder Outflow Obstruction

Pirola, Giacomo Maria; Maggi, Martina; Castellani, Daniele; Sciarra, Alessandro; Rubilotta, Emanuele; Gubbiotti, Marilena

doi:10.2147/rru.s277480

Cited by 7 publications

(11 citation statements)

References 36 publications

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“…About 60% of men with BPH—probably and mainly due to the slow onset of LUTS—live with these symptoms, which eventually could result in the deterioration of bladder function, so the physician is consulted only when the damage is irreversible [ 17 , 18 ]. This issue represents a real socio-economic problem, since it has an impact on both QoL of patients and the health care system that supports the costs of this disease [ 18 , 19 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

B-TURP versus HoLEP: Peri-Operative Outcomes and Complications in Frail Elderly (>75 y.o.) Patients: A Prospective Randomized Study

et al. 2022

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Background: The aim of this study was to compare the peri-operative and functional results between trans-urethral resection of the prostate (TURP) and holmium laser enucleation of the prostate (HoLEP) in the treatment of benign prostatic hyperplasia (BPH) associated with lower urinary tract symptoms (LUTS) in middle-old patients. Materials and Methods: This prospective single-center study included patients over 75 years old treated with B-TURP or HoLEP for BPH associated with LUTS with prostate volume (PV) <100 mL. Primary endpoints were the intra-operative blood loss, percentage of loss of hemoglobin, blood transfusion, complications, and the comparison of functional outcomes. All patients were evaluated at 1, 3, 6, and 12 months of follow-up. Results: Overall, 96 patients undergoing HoLEP and 104 B-TURP were eligible and enrolled for the study. Post-operative results showed statistically significant differences between the two groups, all in favor of HoLEP group, specifically in terms of removed prostate tissue, PV reduction rate, hemoglobin values at 24 h, hemoglobin loss, operative time, length of hospitalization, days of catheterization, and urinary flow rates. There was no significant difference in terms of postvoid residual urine volume, perioperative complication, blood transfusion, International Prostate Symptom Score (IPSS), and IPSS quality of life scores. Conclusions: In middle-old patients, the HoLEP technique represents a prostate size-independent treatment option with a more favorable safety profile defined by less bleeding, lower blood transfusions, and a significantly lower hemoglobin drop than B-TURP.

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Section: Discussionmentioning

confidence: 99%

B-TURP versus HoLEP: Peri-Operative Outcomes and Complications in Frail Elderly (>75 y.o.) Patients: A Prospective Randomized Study

et al. 2022

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“…It is more of a low-cost treatment compared to TURP. Most conveniently, it can be performed in the outpatient operating room (4)(5)(6). Ultrasound-guided transperineal laser ablation (US-TPLA) and prostatic artery embolization (PAE) are new minimally invasive interventional techniques developed in recent years, both of which are suitable for BPH in older people (7,8).…”

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided perineal laser ablation versus prostatic arterial embolization for benign prostatic hyperplasia: two similar short-term efficacies

2022

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Background There are many ways to treat prostatic hyperplasia; these are currently more inclined to minimally invasive treatment. We mainly compared the differences between two treatment methods， ultrasound-guided transperineal laser ablation (US-TPLA) and prostatic artery embolization (PAE). Purpose To evaluate the efficacy and safety of US-TPLA and PAE in the treatment of benign prostatic hyperplasia (BPH). Material and Methods The clinical information for 40 patients with BPH admitted to our hospital between June 2018 and January 2021 were retrospectively analyzed. The changes in International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), postvoid residual (PVR), prostate volume (PV), and the incidence of complications were compared between groups. Results The IPSS ( P < 0.001; P < 0.001), QoL ( P < 0.001; P < 0.001), Qmax ( P < 0.001; P < 0.001), PVR ( P < 0.001; P < 0.001), and PV ( P < 0.001; P < 0.001) at three and six months after US-TPLA and PAE improved with respect to those before surgery. There was no significant difference in IPSS ( P = 0.235; P = 0.151), QoL ( P = 0.527; P = 0.294), Qmax ( P = 0.776; P = 0.420), PVR ( P = 0.745; P = 0.607), and PV ( P = 0.527; P = 0.573) between the groups at three and six months after surgery. No serious complications occurred in either group. Conclusion US-TPLA and PAE seem to have a similar short-term efficacy. The efficacy of the two procedures is comparable, and neither is associated with serious complications. US-TPLA and PAE are both effective complementary measures for the treatment of BPH.

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“…For several decades, transurethral resection of prostate (TURP) has been recognized as the gold-standard endoscopic treatment for symptomatic (BPH) requiring surgery and those who failed medical therapy and may have complications of outlet obstruction such as bladder stones, urinary retention, or renal insufficiency [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Does power setting impact surgical outcomes of holmium laser enucleation of the prostate? A systematic review and meta-analysis

Pirola

Castellani

Maggi

et al. 2022

Cent european J Urol

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Introduction The aim of this article was to enumerate the differences in immediate and postoperative outcomes for holmium laser enucleation of the prostate (HoLEP) performed with low-power (LP) or high-power (HP) laser settings through a systematic review of comparative studies. Material and methods We performed a systematic literature review using MEDLINE, EMBASE, and Cochrane Central Controlled Register of Trials. Potential clinical differences among LP and HP HoLEP were determined using the PICOS (Patient Intervention Comparison Outcome Study type) model, where outcomes were surgical time, operative efficiency, postoperative catheterization time, length of hospital stay, blood transfusion, incontinence rate, maximum urinary flow rate (QMax) and International Prostatic Symptom score (IPSS). Retrospective, prospective nonrandomized, randomized studies, and meeting abstracts were considered. Results A total of five studies were included for meta-analysis. No significant differences between LP and HP HoLEP were evidenced in terms of intraoperative variables (surgical time, surgical efficiency); postoperative outcomes (length of stay, length of catheterization); postoperative complications; functional results (IPSS; Qmax). Urinary incontinence rate did not differ between the two groups (OR 0.95, 95% CI 0.362.47, p = 0.91). Conclusions The study shows equal outcomes in outcomes from HoLEP performed with LP or HP energy settings. Even if further comparative studies are still needed to increase the level of evidence, those results encourage a further clinical adoption of LP HoLEP.

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A Cost–Benefit Analysis of Bipolar TURP for the Treatment of Bladder Outflow Obstruction

Cited by 7 publications

References 36 publications

B-TURP versus HoLEP: Peri-Operative Outcomes and Complications in Frail Elderly (>75 y.o.) Patients: A Prospective Randomized Study

B-TURP versus HoLEP: Peri-Operative Outcomes and Complications in Frail Elderly (>75 y.o.) Patients: A Prospective Randomized Study

Ultrasound-guided perineal laser ablation versus prostatic arterial embolization for benign prostatic hyperplasia: two similar short-term efficacies

Does power setting impact surgical outcomes of holmium laser enucleation of the prostate? A systematic review and meta-analysis

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