Mp62-11 Benign Prostatic Hyperplasia Surgical Retreatment: A Retrospective Cohort Analysis of a Nationwide Database

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology IV (MP62)1 May 2024MP62-11 BENIGN PROSTATIC HYPERPLASIA SURGICAL RETREATMENT: A RETROSPECTIVE COHORT ANALYSIS OF A NATIONWIDE DATABASE Celeste Manfredi, Leslie Licari, Francesco Ditonno, Antonio Franco, Eugenio Bologna, Morgan Sturgis, Marco De Sio, Shaan Setia, Ephrem Olweny, Christopher Coogan, Laurence Levine, Edward Cherullo, and Riccardo Autorino Celeste ManfrediCeleste Manfredi , Leslie LicariLeslie Licari , Francesco DitonnoFrancesco Ditonno , Antonio FrancoAntonio Franco , Eugenio BolognaEugenio Bologna , Morgan SturgisMorgan Sturgis , Marco De SioMarco De Sio , Shaan SetiaShaan Setia , Ephrem OlwenyEphrem Olweny , Christopher CooganChristopher Coogan , Laurence LevineLaurence Levine , Edward CherulloEdward Cherullo , and Riccardo AutorinoRiccardo Autorino View All Author Informationhttps://doi.org/10.1097/01.JU.0001008904.63948.3b.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Benign prostatic hyperplasia (BPH) surgery does not involve removal of the entire gland to avoid the morbidity associated with radical prostatectomy, exposing the patients to the risk of regrowth of prostatic tissue with the need for surgical retreatment. This study aimed to evaluate and compare the need for surgical retreatment after different BPH surgeries. METHODS: We conducted a retrospective analysis based on the PearlDiver™ Mariner database. It is a commercially available, all-payer claims, deidentified, U.S. database, containing over 41 billion Health Insurance Portability and Accountability Act (HIPAA)-compliant patient records collected between 2011 and 2022. Specific International Classification of Diseases (ICD) and Current Procedural Terminology (CPT) codes were used to identify population and outcomes in the database. The following data were described: number and type of BPH surgical procedures, BPH surgical retreatment, and time to BPH surgical retreatment. Surgical retreatment was selected as primary outcome. The data was extracted, categorized, synthesized, and analyzed directly by the R-based software integrated into to the database. The multivariable analysis was performed to evaluate the predictors of BPH surgical retreatment. RESULTS: A total of 274,808 patients undergoing BPH surgery were included. Surgical retreatment rate was 9.4%, ranging between 2.9% (OSP) and 19.0% (PAE) according to the primary technique. Reinterventions were performed within 5 years in 85.5% of cases, this rate varied from 80.3% (HoLEP/ThuLEP) to 100% (Rezum, Aquablation). Time to reoperation was 25.4±26.4 months, ranging between 9.4±8.9 (PAE) and 46.7±21.2 (OSP) months. TUIP (OR 4.55, 95% CI 4.18-5.0, p<0.001), PVP (OR 3.13, 95% CI 3.04-3.23, p<0.001), PUL (OR 3.11, 95% CI 3.0-3.23, p<0.001), Rezum (OR 1.23, 95% CI 1.05-1.9, p=0.038), and PAE (OR 8.52, 95% CI 7.76-9.34, p<0.001) were associated with a significantly greater likelihood of surgical retreatment compared to TURP. HoLEP/ThuLEP were associated with a significantly lower probability of retreatment than TURP (OR 0.69, 95% CI 0.57-0.88, p<0.001), while no significant difference was found for OSP (OR 1.24, 95% CI 0.86-1.85, p=0.084) and LSP/RASP (OR 1.46, 95% CI 0.91-1.94, p=0.211) when compared to HoLEP/ThuLEP. CONCLUSIONS: Less than 10% of patients undergoing BPH surgery require surgical retreatment, most of them within 5 years. TURP appears associated with a significantly lower probability of surgical retreatment than TUIP, PVP, PUL, Rezum, and PAE; while HoLEP/ThuLEP and simple prostatectomy do not seem to differ significantly in the likelihood of reoperation. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1025 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Celeste Manfredi More articles by this author Leslie Licari More articles by this author Francesco Ditonno More articles by this author Antonio Franco More articles by this author Eugenio Bologna More articles by this author Morgan Sturgis More articles by this author Marco De Sio More articles by this author Shaan Setia More articles by this author Ephrem Olweny More articles by this author Christopher Coogan More articles by this author Laurence Levine More articles by this author Edward Cherullo More articles by this author Riccardo Autorino More articles by this author Expand All Advertisement PDF downloadLoading ...