Abstract
Purpose
In France, transurethral resection of the prostate (TURP) is still the most commonly used surgical treatment for medium sized benign prostatic hyperplasia (BPH), but the Holmium Laser Enucleation of the Prostate (HoLEP) and laser vaporization procedures are becoming more common. For these three surgical procedures, we evaluate the initial complications, the short term (3 months) and the 4–12-month postoperative complications necessitating re-hospitalization.
Methods
From the French national hospital data base (PMSI-MCO), all hospitalizations for BPH treatment in 2018 were extracted. We document the complications during the initial hospitalization and any subsequent rehospitalizations during the one-year postoperative period.
Results
In 2018, 67,220 patients were treated for BPH: 46,242 TURP, 13,509 HoLEP and 7469 laser vaporization. Age and anticoagulation medications were similar for men treated by the three procedures, but TURP patients were more often hypertensive. Infections and hemorrhagic complications were the most common complications at the initial hospitalization: 17%, 10%, 13% for infections and 15%, 8.1%, 11% for hemorrhagic complications respectively, and TURP performed worse than the other two procedures at the initial hospitalization. During the first three months and then the subsequent nine months, there were fewer complications than initially, with little difference between the three procedures, all differences being less than 1%.
Conclusion
Laser vaporization techniques led to fewer complications. However, the PMSI-MCO only registers complications during hospitalizations. This study should be extended to non-hospitalized, more minor complications.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data availability
Not applicable.
References
Boyle P, Robertson C, Mazzetta C, Keech M, Hobbs FD, Fourcade R, Kiemeney L, Lee C, UrEpik Study Group (2003) The prevalence of lower urinary tract symptoms in men and women in four centres. The UrEpik study. BJU Int 92:409–414
Robert G, De La Taille A, Descazeaud A (2018) Epidemiology of benign prostatic hyperplasia. Prog Uro 28:821–829
Agreda Castañeda F, Buisan Rueda O, Areal Calama JJ (2020) The complication of the HoLEP learning curve. A systematic review. Actas Urol Esp 44:1–8
Thangasamy IA, Chalasani V, Bachmann A, Woo HH (2012) Photoselective vaporization of the prostate using 80-W and 120-W laser versus transurethral resection of the prostate for benign prostatic hyperplasia: a systematic review with meta-analysis from 2002 to 2012. Eur Urol 62:315–323
Bach T, Wölbling F, Gross AJ, Netsch C, Tauber S, Pottek T, Wülfing C, Brunken C (2017) Prospective assessment of perioperative course in 2648 patients after surgical treatment of benign prostatic obstruction. World J Urol 5:285–292
Ahyai SA, Gilling P, Kaplan SA, Kuntz RM, Madersbacher S, Montorsi F, Speakman MJ, Stief CG (2010) Meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic enlargement. Eur Uro 58:384–397
Thomas JA, Tubaro A, Barber N, d’Ancona F, Muir G, Witzsch U, Grimm MO, Benejam J, Stolzenburg JU, Riddick A, Pahernik S, Roelink H, Ameye F, Saussine C, Bruyère F, Loidl W, Larner T, Gogoi NK, Hindley R, Muschter R, Thorpe A, Shrotri N, Graham S, Hamann M, Miller K, Schostak M, Capitán C, Knispel H, Bachmann A (2016) A multicenter randomized noninferiority trial comparing greenlight-XPS laser vaporization of the prostate and transurethral resection of the prostate for the treatment of benign prostatic obstruction: 2-yr outcomes of the GOLIATH study. Eur Urol 69:94–102
Gilling PJ, Wilson LC, King CJ, Westenberg AM, Frampton CM, Fraundorfer MR (2012) Long-term results of a randomized trial comparing holmium laser enucleation of the prostate and transurethral resection of the prostate: results at 7 years. BJU Int 109:408–411
Kumar A, Vasudeva P, Kumar N, Nanda B, Jha SK, Mohanty N (2013) A prospective randomized comparative study of monopolar and bipolar transurethral resection of the prostate and photoselective vaporization of the prostate in patients who present with benign prostatic obstruction: a single center experience. J Endourol 27:1245–1253
Zhang Y, Yuan P, Ma D, Gao X, Wei C, Liu Z, Li R, Wang S, Liu J, Liu X (2019) Efficacy and safety of enucleation vs resection of prostate for treatment of benign prostatic hyperplasia: a meta-analysis of randomized controlled trials. Prostate Cancer Prostatic Dis 22:493–508
Yin L, Teng J, Huang CJ, Zhang X, Xu D (2013) Holmium laser enucleation of the prostate versus transurethral resection of the prostate: a systematic review and meta-analysis of randomized controlled trials. J Endourol 27:604–611
Lai S, Peng P, Diao T, Hou H, Wang X, Zhang W, Liu M, Zhang Y, Seery S, Wang J (2019) Comparison of photoselective green light laser vaporization versus traditional transurethral resection for benign prostate hyperplasia: an updated systematic review and meta-analysis of randomized controlled trial and prospective studies. BMJ Open 9:e028855
Georgescu I, Hartmann F (2013) Sources of financial pressure and up coding behaviour in French public hospitals. Health Policy 110:156–463
Author information
Authors and Affiliations
Contributions
AB: protocol/project development, data collection or management, data analysis, manuscript writing/editing. JS: data analysis. CM: protocol/project development. CL: protocol/project development. AD: data collection or management. BB: data analysis, manuscript writing/editing. JH: data analysis, manuscript writing/editing. PE: manuscript writing/editing, protocol/project development, data analysis.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no relevant conflict of interest.
Research involving human participants and/or animals
The following manuscript is a review of existing data and does not contain any studies with human participants or animals.
Informed consent
A formal consent is not required for this type of study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Behr, A., Salleron, J., Mazeaud, C. et al. Comparison of surgical procedures for benign prostatic hyperplasia of medium-volume prostates: evaluation of the causes of rehospitalization from the French National Hospital Database (PMSI-MCO). World J Urol 41, 2481–2488 (2023). https://doi.org/10.1007/s00345-023-04509-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00345-023-04509-6