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Real-world data comparing minimally invasive surgeries for benign prostatic hyperplasia

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Abstract

Objectives

To assess the differences in surgical outcomes between the prostatic urethral lift (PUL) and previous thermal energy procedures for the treatment of benign prostatic hyperplasia (BPH).

Methods

We present an observational population-based study of 2694 men with BPH in New York State and California who received PUL, transurethral needle ablation (TUNA), or transurethral microwave therapy (TUMT) in outpatient and ambulatory surgery settings from 2005 to 2018. For these surgical procedures, short-term outcomes were reported and compared using a Chi-square test and mixed-effect logistic regressions. Long-term outcomes were described using Kaplan–Meier failure curves and compared using a Log-rank test and Cox regressions.

Results

A significant portion of PUL patients had a comorbidity count ≥ 2 (n = 838, 37.0%). PUL exhibited the lowest 30 day and 90-day inpatient or ER readmission rates among all surgical techniques except for 90-day ER readmission (p < 0.05). No differences were observed for 1- and 3-year risks of reoperation between PUL [5.5% (95% CI 4.4–6.8%) and 14.9% (95% CI 10.9–20.1%)], TUNA [7.4% (95% CI 5.0–10.9%) and 11.3% (95% CI 8.3–15.4%)] and TUMT [8.5% (95% CI 4.7–15.2%) and 15.3% (95% CI 9.5–24.0%)]. 1- and 3-year risks of stricture development for PUL were 0.2% (95% CI 0.0–0.7%) and 0.2% (95% CI 0.0–0.07%), respectively.

Conclusion

In a patient population with chronic conditions, patients treated with PUL exhibited similar 30- and 90-day inpatient or ER readmission rates when compared to previous reports. However, 1- and 3-year reoperation risks for PUL closely resembled previous thermal energy surgical procedures.

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Authors and Affiliations

  1. Division of Urology, Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada

    Brendan L. Raizenne, Kevin C. Zorn & Naeem Bhojani

  2. Department of Population Health Sciences, Weill Cornell Medical College/New York Presbyterian, New York, NY, USA

    Xinyan Zheng, Jialin Mao, Art Sedrakyan & Bilal Chughtai

  3. Division of Urology, University Health Network, University of Toronto, Toronto, ON, Canada

    Dean Elterman

  4. Department of Urology, Weill Cornell Medical College/New York Presbyterian, 425 East 61st St., 12th Floor, New York, NY, 10065, USA

    Ahra Cho & Bilal Chughtai

Authors
  1. Brendan L. Raizenne
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  2. Xinyan Zheng
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  3. Jialin Mao
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  4. Kevin C. Zorn
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  5. Ahra Cho
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  6. Dean Elterman
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  7. Naeem Bhojani
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  8. Art Sedrakyan
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  9. Bilal Chughtai
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Contributions

BLR data collection, manuscript writing. XZ data collection, data analysis, manuscript writing. JM data collection, data analysis, manuscript editing. KCZ manuscript editing. AC manuscript editing. DE manuscript editing. NB manuscript editing. AS project development. BC project development, manuscript editing.

Corresponding author

Correspondence to Bilal Chughtai.

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Conflict of interest

NB is a consultant and investigator for Boston Scientific, Olympus, and PROCEPT BioRobotics. BC is a consultant and investigator for Boston Scientific, Olympus and Prodeon. KCZ is a consultant for Boston Scientific, and PROCEPT BioRobotics. DE is consultant and investigator for Boston Scientific, PROCEPT BioRobotics, Prodeon, Olympus, Urotronic, and Zenflow. All other authors report no relevant conflicts of interest.

Compliance with ethical standards research involving human participants

The data used to produce this publication was provided by the New York State Department of Health (NYSDOH). However, the conclusions derived, and views expressed therein are those of the author(s) and do not reflect the conclusions or views of NYSDOH. NYSDOH, its employees, officers, and agents make no representation, warranty or guarantee as to the accuracy, completeness, currency, or suitability of the information provided here.

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Raizenne, B.L., Zheng, X., Mao, J. et al. Real-world data comparing minimally invasive surgeries for benign prostatic hyperplasia. World J Urol 40, 1185–1193 (2022). https://doi.org/10.1007/s00345-021-03926-9

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  • DOI: https://doi.org/10.1007/s00345-021-03926-9

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