Mp57-13 Is Bipolar Enucleation of the Prostate an Effective and Cost-Efficient Alternative to Robotic Simple Prostatectomy?

You have accessJournal of UrologyHealth Services Research: Value of Care: Cost and Outcomes II (MP57) 1 May 2024MP57-13 IS BIPOLAR ENUCLEATION OF THE PROSTATE AN EFFECTIVE AND COST-EFFICIENT ALTERNATIVE TO ROBOTIC SIMPLE PROSTATECTOMY? Uy Lae Kim, Sikai Song, Jammie-Lyn Quines, David Benjamin, Ala'a Farkouh, Akin S. Amasyali, Kai Wen Cheng, Evan Seibly, Zhamshid Okhunov, and D. Duane Baldwin Uy Lae KimUy Lae Kim, Sikai SongSikai Song, Jammie-Lyn QuinesJammie-Lyn Quines, David BenjaminDavid Benjamin, Ala'a FarkouhAla'a Farkouh, Akin S. AmasyaliAkin S. Amasyali, Kai Wen ChengKai Wen Cheng, Evan SeiblyEvan Seibly, Zhamshid OkhunovZhamshid Okhunov, and D. Duane BaldwinD. Duane Baldwin View All Author Informationhttps: //doi. org/10. 1097/01. JU. 0001009420. 83948. eb. 13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Holmium-laser enucleation of the prostate (HoLEP) and robotic-assisted simple prostatectomy (RASP) are accepted minimally invasive treatments for large prostates. However, both these procedures require costly capital expenditures and specially trained staff that may not be available in all centers. Recently, bipolar transurethral enucleation of the prostate (B-TUEP) has been described as a minimally invasive alternative for BPH, utilizing standard transurethral equipment available at all centers. However, there is no literature comparing cost between B-TUEP and RASP. The purpose of this study was to compare the efficacy, safety, and cost of B-TUEP compared to RASP. METHODS: A retrospective chart review of patients with symptomatic BPH in a single academic institution who underwent a B-TUEP or RASP was performed from February 2016 to June 2023. Clinical co-variates were collected, including demographics, medical co-morbidities, prostate size, and IPSS scores. Perioperative outcomes were assessed and compared, including operative time, blood loss, length of stay, post-op complications, and cost. Statistical analysis was performed using a two-tailed t-test, Wilcoxon signed-rank test, and Pearson Chi-square test, with p<0. 05 considered significant. RESULTS: A total of 125 patients were included, with 84 undergoing B-TUEP and 41 undergoing RASP. Significant baseline demographic differences between the surgery groups included a smaller average prostate size in the B-TUEP group (114 vs 163 g; p<0. 001) and a lower percentage of catheter-dependent patients compared to the RASP group (23. 8% vs 41. 5%; p=0. 042). B-TUEP had shorter operative times (110 vs 257 min; p<0. 001), decreased blood loss (75 vs 209 ml; p<0. 001), shorter hospital stays (0. 49 vs 1. 73 days; p<0. 001), and shorter catheterization durations (3. 24 vs 11. 29 days; p<0. 001) compared to RASP. There was no significant difference in overall complications (p=0. 19) and mean postoperative IPSS scores (p=0. 3) between the two groups. Finally, the mean perioperative and total costs of performing B-TUEP compared to RASP were significantly less (perioperative costs: 4, 638. 81 vs 10, 040. 36; p<0. 001 and total cost: 9, 802. 76 vs 21, 737. 57; p<0. 001). CONCLUSIONS: B-TUEP provides improved outcomes and reduces cost by 55% compared to RASP. B-TUEP is a promising option for relief of symptomatic prostatic obstruction in patients with large prostates, and may be particularly desirable in centers without access to high-powered lasers or surgical robots. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc. FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e943 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc. Metrics Author Information Uy Lae Kim More articles by this author Sikai Song More articles by this author Jammie-Lyn Quines More articles by this author David Benjamin More articles by this author Ala'a Farkouh More articles by this author Akin S. Amasyali More articles by this author Kai Wen Cheng More articles by this author Evan Seibly More articles by this author Zhamshid Okhunov More articles by this author D. Duane Baldwin More articles by this author Expand All Advertisement PDF downloadLoading. . .