David Bouhadana1, David-Dan Nguyen1, Xinyan Zhang2, Jialin Mao2, Dean S Elterman3, Alexis E Te4, Kevin C Zorn5, Naeem Bhojani3, Art Sedrakyan2, Bilal Chughtai6. 1. Faculty of Medicine, McGill University, Montreal, QC, Canada. 2. Department of Healthcare Policy and Research, Weill Cornell Medical College-New York Presbyterian, New York, NY, USA. 3. Division of Urology, Dept. of Surgery, University Health Network, University of Toronto, Toronto, ON, Canada. 4. Department of Urology, Weill Cornell Medical College/New York Presbyterian, 425 East 61st St., 12th Floor, New York, NY, 10065, USA. 5. Division of Urology, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada. 6. Department of Urology, Weill Cornell Medical College/New York Presbyterian, 425 East 61st St., 12th Floor, New York, NY, 10065, USA. bic9008@med.cornell.edu.
Abstract
PURPOSE: To compare the safety and durability of transurethral resection of the prostate (TURP) and Laser prostatectomy (LP) among multi-morbid and elderly patients. METHODS: Using data retrieved from the New York State Department of Health Statewide Planning and Research Cooperative System and the California Office of Statewide Health Planning and Development, we selected cohorts of 1) multi-morbid (Charlson comorbidity index ≥ 3) and 2) elderly (aged ≥ 75) patients with benign prostatic hyperplasia who underwent laser coagulation, vaporization, enucleation, or TURP between January 2005 and December 2016. We assessed the post-operative incidence of hospital readmission and ER visit at 30 days and 90 days, complications at 90 days, and reoperation and the development of urethral stricture at 6 months or longer. RESULTS: We found 12,815 and 29,806 patients in the multi-morbid and elderly cohort, respectively. Compared to LP, TURP was associated with lower odds of 90-day hospital readmission and ER visit in the multi-morbid cohort (OR 0.92, 95% CI 0.85-1.00) and higher odds in the elderly cohort (OR 1.07, 95% CI 1.01-1.14). The multi-morbid cohort showed lower odds of urinary tract infections (Ref: LP, OR 0.83, 95% CI 0.73-0.93). The elderly cohort showed higher odds of experiencing hematuria (OR 1.28, 95% CI 1.03-1.59) post TURP. TURP was associated with a 19% (95% CI 0.66-1.00) and 20% (95% CI 0.71-0.91) reduced hazard of reoperation at 6 months or longer for multi-morbid and elderly cohorts, respectively. CONCLUSION: Compared to LP, TURP was associated with higher complication rates for the multi-morbid and elderly cohorts overall but a lower hazard of reoperation, supporting its durability.
PURPOSE: To compare the safety and durability of transurethral resection of the prostate (TURP) and Laser prostatectomy (LP) among multi-morbid and elderly patients. METHODS: Using data retrieved from the New York State Department of Health Statewide Planning and Research Cooperative System and the California Office of Statewide Health Planning and Development, we selected cohorts of 1) multi-morbid (Charlson comorbidity index ≥ 3) and 2) elderly (aged ≥ 75) patients with benign prostatic hyperplasia who underwent laser coagulation, vaporization, enucleation, or TURP between January 2005 and December 2016. We assessed the post-operative incidence of hospital readmission and ER visit at 30 days and 90 days, complications at 90 days, and reoperation and the development of urethral stricture at 6 months or longer. RESULTS: We found 12,815 and 29,806 patients in the multi-morbid and elderly cohort, respectively. Compared to LP, TURP was associated with lower odds of 90-day hospital readmission and ER visit in the multi-morbid cohort (OR 0.92, 95% CI 0.85-1.00) and higher odds in the elderly cohort (OR 1.07, 95% CI 1.01-1.14). The multi-morbid cohort showed lower odds of urinary tract infections (Ref: LP, OR 0.83, 95% CI 0.73-0.93). The elderly cohort showed higher odds of experiencing hematuria (OR 1.28, 95% CI 1.03-1.59) post TURP. TURP was associated with a 19% (95% CI 0.66-1.00) and 20% (95% CI 0.71-0.91) reduced hazard of reoperation at 6 months or longer for multi-morbid and elderly cohorts, respectively. CONCLUSION: Compared to LP, TURP was associated with higher complication rates for the multi-morbid and elderly cohorts overall but a lower hazard of reoperation, supporting its durability.
Authors: Bilal I Chughtai; Vannita Simma-Chiang; Richard Lee; Abby Isaacs; Alexis E Te; Steven A Kaplan; Art Sedrakyan Journal: J Endourol Date: 2014-12-11 Impact factor: 2.942
Authors: James A Thomas; Andrea Tubaro; Neil Barber; Frank d'Ancona; Gordon Muir; Ulrich Witzsch; Marc-Oliver Grimm; Joan Benejam; Jens-Uwe Stolzenburg; Antony Riddick; Sascha Pahernik; Herman Roelink; Filip Ameye; Christian Saussine; Franck Bruyère; Wolfgang Loidl; Tim Larner; Nirjan-Kumar Gogoi; Richard Hindley; Rolf Muschter; Andrew Thorpe; Nitin Shrotri; Stuart Graham; Moritz Hamann; Kurt Miller; Martin Schostak; Carlos Capitán; Helmut Knispel; Alexander Bachmann Journal: Eur Urol Date: 2015-08-15 Impact factor: 20.096
Authors: David-Dan Nguyen; Claudia Deyirmendjian; Kyle Law; Naeem Bhojani; Dean S Elterman; Bilal Chughtai; Franck Bruyère; Luca Cindolo; Giovanni Ferrari; Carlos Vasquez-Lastra; Tiago Borelli-Bovo; Edgardo F Becher; Hannes Cash; Maximillian Reimann; Enrique Rijo; Vincent Misrai; Kevin C Zorn Journal: World J Urol Date: 2022-03-26 Impact factor: 4.226