Minimally Invasive Treatment for Benign Prostatic Hyperplasia: Economic Evaluation from a Standardized Hospital Case Costing System

  • Andrew D. Brown
  • Steffan F. Stella
  • Martin E. Simons
Clinical Investigation Arterial Interventions
Part of the following topical collections:
  1. Arterial Interventions



Minimally invasive alternatives to transurethral resection of the prostate (TURP) such as prostate arterial embolization (PAE) and photoselective vaporization of the prostate (PVP) are being explored as adjuncts in the care of patients with benign prostatic hyperplasia. However, there are conflicting reports of the costs of these procedures. The purpose of this study was to compare the direct and indirect hospital costs of TURP, PAE and PVP.

Materials and Methods

A chart review was performed in patients who underwent TURP, PVP and PAE from April 2015 to March 2017. All hospital costs were collected in accordance with the Ontario Case Costing Initiative, a standardized medical case costing system. Costs were characterized as direct or indirect and fixed or variable. Probabilistic sensitivity analysis was conducted to study cost uncertainty.


During the study period, a total of 209 men underwent TURP, 28 PVP and 21 PAE. Mean age (years) was as follows: TURP 71.43; PVP 73.66; PAE 70.77 (p = 0.366). Mean length of stay (days) was as follows: TURP 1.63; PVP 1.55; PAE 1 (p = 0.076). Total costs of the PAE group ($3829, SD $1582) were less than both PVP ($5719, SD $1515) and TURP groups ($5034, SD $1997, p < 0.001). There was no significant difference in direct costs between the groups. Monte Carlo simulation demonstrated that PAE was the least costly alternative majority of the time.


The total hospital costs of PAE at our institution are significantly lower than those of PVP and TURP.


BPH Cost Prostate artery embolization (PAE) Photoselective vaporization of the prostate (PVP) TURP 


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

For this type of study, formal consent is not required.

Informed Consent

This study has obtained IRB approval from research ethics board (University Health Network), and the need for informed consent was waived.

Consent for Publication

For this type of study, consent for publication is not required.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2018

Authors and Affiliations

  • Andrew D. Brown
    • 1
  • Steffan F. Stella
    • 2
  • Martin E. Simons
    • 1
  1. 1.Division of Vascular and Interventional Radiology, Department of Medical Imaging, Toronto General Hospital, University Health NetworkUniversity of TorontoTorontoCanada
  2. 2.Division of Vascular and Interventional Radiology, Department of Radiology, Hamilton Health Sciences, McMaster University Medical CentreMcMaster UniversityHamiltonCanada

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