1. Perioperative Outcomes of Transurethral Resection, Open Prostatectomy, and Laser Therapy in the Surgical Treatment of Benign Prostatic Obstruction: A 'Real-World' Data Analysis from the URO-Cert Prostate Centers
- Author
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Sebastian Schmidt, Winfried Czempiel, Eckart Gronau, W. Schafhauser, W. Schultze-Seemann, Ehsan Khaljani, Stephan Buse, Herbert Ruebben, Jon Jones, Alexander Goell, P. Weib, Florian Distler, Thomas Ebert, Juergen Zumbe, Bernhard Planz, Daniel Porres, Martin Kriegmair, Jana Pretzer, Michael Reimann, Frank Oberpenning, G. Haupt, Michael Waldner, Miguel Garcia Schürmann, Guido Platz, Axel Heidenreich, Sven Laabs, Daniel Schlager, Maximilian Cohausz, and J. Herden
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Databases, Factual ,Urology ,medicine.medical_treatment ,Prostatic Hyperplasia ,Postoperative Complications ,Laser therapy ,Lower Urinary Tract Symptoms ,Prostate ,Lower urinary tract symptoms ,Germany ,medicine ,Humans ,Blood Transfusion ,Surgical treatment ,Transurethral resection of the prostate ,Aged ,business.industry ,Transurethral Resection of Prostate ,Perioperative ,Recovery of Function ,Length of Stay ,medicine.disease ,Surgery ,Urodynamics ,medicine.anatomical_structure ,Treatment Outcome ,Retreatment ,Laser Therapy ,Prostatic obstruction ,business ,Open Prostatectomy - Abstract
Introduction: The aim of the study is to compare length of hospital stay, transfusion rates, and re-intervention rates during hospitalization for transurethral resection of the prostate (TUR-P), open prostatectomy (OP), and laser therapy (LT) for surgical treatment of benign prostatic obstruction (BPO). Methods: URO-Cert is an organization, in which clinical data of prostatic diseases from 2 university, 19 public, and 3 private hospitals and 270 office-based urologists are collected in order to document treatment quality. Data on diagnostics, therapy, and course of disease are recorded web based. The analysis includes datasets from 2005 to 2017. Results: Of 10,420 patients, 8,389 were treated with TUR-P, 1,334 with OP, and 697 with LT. Median length of hospital stay was 6 days (IQR: 4–7) for TUR-P, 9 days (IQR: 7–11) for OP, and 5 days (IQR: 4–6) for LT (p < 0.001). Risk for a hospital stay ≥7 days was higher for OP versus TUR-P (OR: 7.25; 95% CI = 6.27–8.36; p < 0.001) and LT (OR: 17.89; 95% CI = 14.12–22.65; p < 0.001) and higher for TUR-P versus LT (OR: 2.47; 95% CI = 2.03–3.01; p < 0.001). OP had a significantly higher risk for transfusions than TUR-P (OR: 2.44; 95% CI = 1.74–3.41; p < 0.001) and LT (OR: 3.32; 95% CI = 1.56–7.01; p < 0.001). Transfusion rates were not significantly different between TUR-P and LT (OR: 1.36; 95% CI = 0.66–2.79; p = 0.51). Risk of re-intervention was not different between all 3 approaches. Conclusion: OP was associated with higher transfusion rates and longer hospital stay than TUR-P and LT. Risk of transfusion was not different between TUR-P and LT, but TUR-P was inferior to LT concerning length of hospital stay. Re-intervention rates during hospitalization did not differ between the groups.
- Published
- 2020