Cost Analysis of Prostate Artery Embolization (PAE) and Transurethral Resection of the Prostate (TURP) in the Treatment of Benign Prostatic Hyperplasia

Abstract

Purpose

Prostatic arterial embolization (PAE) has emerged as a minimally invasive alternative to TURP; however, there are limited cost comparisons reported. The purpose of this study was to compare in-hospital direct costs of elective PAE and TURP in a hospital setting.

Materials and Methods

Institutional Review Board-approved retrospective review was performed on patients undergoing PAE and TURP from January to December 2014. Inclusion criteria included male patients greater than 40 years of age who presented for ambulatory TURP or PAE with no history of prior surgical intervention for BPH. Direct costs were categorized into the following categories: nursing and operating room or interventional room staffing, operating room or interventional supply costs, anesthesia supplies, anesthesia staffing, hospital room cost, radiology, and laboratory costs. Additionally, length of stay was evaluated for both groups.

Results

The mean patient age for the TURP (n = 86) and PAE (n = 70) cohorts was 71.3 and 64.4 years, respectively (p < 0.0001). Intra-procedural supplies for PAE were significantly more costly than TURP ($1472.77 vs $1080.84, p < 0.0001). When including anesthesia supplies and nursing/staffing, costs were significantly more expensive for TURP than PAE ($2153.64 vs $1667.10 p < 0.0001). The average length of stay for the TURP group was longer at 1.38 versus 0.125 days for the PAE group. Total in-hospital costs for the TURP group ($5338.31, SD $3521.17) were significantly higher than for PAE ($1678.14, SD $442.0, p < 0.0001).

Conclusions

When compared to TURP, PAE was associated with significantly lower direct in-hospital costs and shorter hospital stay.

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References

  1. 1.

    AUA Practice Guidelines Committee. American urological association guideline: management of benign prostatic hyperplasia. J Urol. 2010.

  2. 2.

    Wei JT, Calhoun E, Jacobsen SJ. Urologic diseases in America project: benign prostatic hyperplasia. Urology. 2005;173:1256–61.

    Article  Google Scholar 

  3. 3.

    Carnevale FC, Antunes AA, da Motta Leal Filho JM, de Oliveira Cerri LM, Baroni RH, Marcelino AS, Freire GC, Moreira AM, Srougi M, Cerri GG. Prostatic artery embolization as a primary treatment for benign prostatic hyperplasia: preliminary results in two patients. Cardiovasc Intervent Radiol. 2010;33(2):355–61. doi:10.1007/s00270-009-9727-z.

    Article  PubMed  Google Scholar 

  4. 4.

    Kurbatov P, Russo GI, Lepetukhin A, et al. Prostatic artery embolization for prostate volume greater then 80 cm3: results from a single center projective study. Urology. 2014;84:400–4.

    Article  PubMed  Google Scholar 

  5. 5.

    Pisco JM, et al. Medium- and long-term outcome of prostate artery embolization for patients with benign prostatic hyperplasia: results in 630 patients. J Vasc Intvent Radiol. 2016;27:1115–22.

    Article  Google Scholar 

  6. 6.

    Uflacker A, Haskal ZJ, Bilhim T, Patrie J, Huber T, Pisco JM. Meta-analysis of prostatic artery embolization for benign prostatic hyperplasia. J Vasc Interv Radiol. 2016;. doi:10.1016/j.jvir.2016.08.004.

    PubMed  Google Scholar 

  7. 7.

    Bagla S, Smirniotopoulos JB, Orlando JC, van Breda A, Vadlamudi V. Comparative analysis of prostate volume as a predictor of outcome in prostate artery embolization. J Vasc Interv Radiol. 2015;26(12):1832–8. doi:10.1016/j.jvir.2015.08.018.

    Article  PubMed  Google Scholar 

  8. 8.

    Carnevale FC, Iscaife A, Yoshinaga EM, Moreira AM, Antunes AA, Srougi M. Transurethral resection of the prostate (TURP) versus original and PErFecTED prostate arteryembolization (PAE) due to benign prostatic hyperplasia (bph): preliminary results of a single center, prospective, urodynamic-controlled analysis. Cardiovasc Interv Radiol. 2016;39(1):44–52. doi:10.1007/s00270-015-1202-4.

    Article  Google Scholar 

  9. 9.

    Uflacker A, Haskal ZJ, Bilhim T, Patrie J, Huber T, Pisco JM. Meta-analysis of prostatic artery embolization for benign prostatic hyperplasia. J Vasc Interv Radiol. 2016;27(11):1686–97. doi:10.1016/j.jvir.2016.08.004.

    Article  PubMed  Google Scholar 

  10. 10.

    Gao YA, Huang Y, Zhang R, Yang YD, Zhang Q, Hou M, Wang Y. Benign prostatic hyperplasia: prostatic arterial embolization versus transurethral resection of the prostate—a prospective, randomized, and controlled clinical trial. Radiology. 2014;270(3):920–8. doi:10.1148/radiol.13122803.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This study was funded by the SIR Foundation Harvey L. Neiman Health Policy Institute Cost-effectiveness and Quality Outcomes Research Grant program.

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Correspondence to Sandeep Bagla.

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Conflict of interest

Sandeep Bagla, John Smirniotopoulos, Julie Orlando, and Rachel Piechowiak have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Bagla, S., Smirniotopoulos, J., Orlando, J. et al. Cost Analysis of Prostate Artery Embolization (PAE) and Transurethral Resection of the Prostate (TURP) in the Treatment of Benign Prostatic Hyperplasia. Cardiovasc Intervent Radiol 40, 1694–1697 (2017). https://doi.org/10.1007/s00270-017-1700-7

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Keywords

  • Prostate artery embolization (PAE)
  • Cost
  • TURP
  • BPH