Impact of Minimally Invasive Benign Prostatic Hyperplasia Therapies on 30- and 90-Day Postoperative Office Encounters

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• 作者：Ram A. Pathakp>ap> ; Gregory A. Broderickp>ap> ; Todd C. Igelp>ap> ; Steven P. Petroup>ap> ; Paul R. Youngp>ap> ; Michael J. Wehlep>ap> ; Michael G. Heckmanp>bp> ; Nancy N. Diehlp>bp> ; Emily R. Vargasp>bp> ; Kandarp Shahp>ap>p> ; p>p>cp> ; David D. Thielp>ap>p> ; p>p>Thiel.David@mayo.edup>
• 刊名：Urology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：99
• 期：Complete
• 页码：186-191
• 全文大小：152 K
• 卷排序：99

文摘

To compare the frequency of postoperative encounters in the 30-day and 90-day postoperative periods for various bladder outlet obstruction surgical therapies.Materials and MethodsAll patients who underwent transurethral resection of the prostate (TURP), GreenLight laser photovaporization of the prostate (GL-PVP) (American Medical Systems Inc.), and holmium laser enucleation of the prostate (HoLEP) from January 1, 2012 to December 31, 2014 were followed for 6 months postoperatively. All postoperative encounters such as patient calls or questions, catheter exchanges or removals, and hospital-based readmissions or emergency department visits were recorded in the electronic medical record.ResultsTwo hundred and ninety-one consecutive patients underwent outlet procedures during the study period: TURP (N&thinsp;=&thinsp;199; mean age, 71 years; mean body mass index [BMI], 28.5), HoLEP (N&thinsp;=&thinsp;60; mean age, 68 years; mean BMI, 28.1), or GL-PVP (N&thinsp;=&thinsp;32; mean age, 72 years; mean BMI, 29.3). No statistically significant difference was observed for age, BMI, preoperative American Urological Association symptom score, or preoperative maximum flow velocity between the 3 groups. Thirty-day postoperative encounters differed significantly between the 3 surgery types (P&thinsp;<&thinsp;.001). Specifically, there were fewer encounters within 30 days of surgery for TURP compared to both HoLEP (≥1 encounter: TURP&thinsp;=&thinsp;48.7%, HoLEP&thinsp;=&thinsp;66.7%; P&thinsp;=&thinsp;.006) and GL-PVP (≥1 encounter: TURP&thinsp;=&thinsp;48.7%, GL-PVP&thinsp;=&thinsp;93.7%; P&thinsp;<&thinsp;.001). The number of encounters within 90 days postoperatively was also significantly lower for TURP patients (P&thinsp;<&thinsp;.001).ConclusionTURP results in fewer postoperative encounters in both the 30-day and 90-day postoperative periods compared to HoLEP and GL-PVP. Laser prostate therapies may place increased burden on clinic staff during the 30-day and 90-day postoperative periods.