Trends in the surgical treatment of benign prostatic hyperplasia in a tertiary hospital

Darren Ow, Nathan Papa, Marlon Perera, Peter Liodakis, Shomik Sengupta, Stephen Clarke, Damien M. Bolton, Nathan Lawrentschuk

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4 Citations (Scopus)

Abstract

Background: To assess current treatment trends and perioperative outcomes of transurethral resection of the prostate (TURP) and photoselective vaporization of the prostate (PVP) in a tertiary institution. Methods: We prospectively collected a database of all patients undergoing TURP and PVP for benign prostatic hyperplasia (BPH) at a tertiary hospital between January 2011 and December 2013. Patient characteristics such as length of stay, readmission, anticoagulation status, American Society of Anesthesiologists (ASA) score and need for blood transfusion were recorded and analysed. Results: In total, 560 cases were included: 204 (36.4%) underwent TURP and 356 (63.6%) PVP. Patients undergoing PVP had higher ASA scores (P < 0.001) and were more frequently on continuing anticoagulant therapy (P < 0.001). With regards to non-aspirin/asasantin coagulation therapy, 61 (17.1%) patients underwent PVP with their anticoagulants continued while no patients who received TURP continued anticoagulation. Blood transfusion percentages were similar at 1.0% for TURP and 1.7% for PVP but readmission proportions were higher after PVP (32 patients, 9.0%) compared to TURP (10 patients, 4.9%). These differences were attenuated when excluding patients continuing anticoagulation during the procedure. Conclusion: At our institution, the use of PVP has been increasing on a year-by-year basis. The results of the current study demonstrated that PVP is safe in patients with increased anaesthetic risk or on active anticoagulation when compared to traditional TURP. While this makes PVP an attractive alternative to TURP in high-risk anticoagulated patients, these patients may have complex post-discharge issues that should be addressed during the informed consent process.

Original languageEnglish
Pages (from-to)95-99
Number of pages5
JournalANZ Journal of Surgery
Volume88
Issue number1-2
DOIs
Publication statusPublished - 1 Jan 2018
Externally publishedYes

Keywords

  • anticoagulant
  • benign prostatic hyperplasia
  • laser therapy
  • photovaporization
  • risk factor
  • urology

Cite this

Ow, D., Papa, N., Perera, M., Liodakis, P., Sengupta, S., Clarke, S., ... Lawrentschuk, N. (2018). Trends in the surgical treatment of benign prostatic hyperplasia in a tertiary hospital. ANZ Journal of Surgery, 88(1-2), 95-99. https://doi.org/10.1111/ans.13904