Holmium laser prostatectomy in a tertiary Italian center: A prospective cost analysis in comparison with bipolar TURP and open prostatectomy
Objective: To assess the economic impact of Holmium laser enucleation of prostate (HoLEP) in comparison with transurethral resection of prostate (TURP) and open prostatectomy (OP). Methods: Between January 2017 and January 2018, we prospectively enrolled 151 men who underwent HoLEP, TURP or OP at...
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PAGEPress Publications
2020-06-01
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Series: | Archivio Italiano di Urologia e Andrologia |
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Online Access: | https://www.pagepressjournals.org/index.php/aiua/article/view/8117 |
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doaj-73406f2ecf9e4ad59ba76fe1b3b4dd41 |
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record_format |
Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Riccardo Schiavina Lorenzo Bianchi Marco Giampaoli Marco Borghesi Hussam Dababneh Francesco Chessa Cristian Pultrone Andrea Angiolini Umberto Barbaresi Matteo Cevenini Fabio Manferrari Alessandro Bertaccini Angelo Porreca Eugenio Brunocilla |
spellingShingle |
Riccardo Schiavina Lorenzo Bianchi Marco Giampaoli Marco Borghesi Hussam Dababneh Francesco Chessa Cristian Pultrone Andrea Angiolini Umberto Barbaresi Matteo Cevenini Fabio Manferrari Alessandro Bertaccini Angelo Porreca Eugenio Brunocilla Holmium laser prostatectomy in a tertiary Italian center: A prospective cost analysis in comparison with bipolar TURP and open prostatectomy Archivio Italiano di Urologia e Andrologia HoLEP; Xost analysis; TURP; Open prostatectomy; Prostatic enlargement |
author_facet |
Riccardo Schiavina Lorenzo Bianchi Marco Giampaoli Marco Borghesi Hussam Dababneh Francesco Chessa Cristian Pultrone Andrea Angiolini Umberto Barbaresi Matteo Cevenini Fabio Manferrari Alessandro Bertaccini Angelo Porreca Eugenio Brunocilla |
author_sort |
Riccardo Schiavina |
title |
Holmium laser prostatectomy in a tertiary Italian center: A prospective cost analysis in comparison with bipolar TURP and open prostatectomy |
title_short |
Holmium laser prostatectomy in a tertiary Italian center: A prospective cost analysis in comparison with bipolar TURP and open prostatectomy |
title_full |
Holmium laser prostatectomy in a tertiary Italian center: A prospective cost analysis in comparison with bipolar TURP and open prostatectomy |
title_fullStr |
Holmium laser prostatectomy in a tertiary Italian center: A prospective cost analysis in comparison with bipolar TURP and open prostatectomy |
title_full_unstemmed |
Holmium laser prostatectomy in a tertiary Italian center: A prospective cost analysis in comparison with bipolar TURP and open prostatectomy |
title_sort |
holmium laser prostatectomy in a tertiary italian center: a prospective cost analysis in comparison with bipolar turp and open prostatectomy |
publisher |
PAGEPress Publications |
series |
Archivio Italiano di Urologia e Andrologia |
issn |
1124-3562 2282-4197 |
publishDate |
2020-06-01 |
description |
Objective: To assess the economic impact of Holmium laser enucleation of prostate (HoLEP) in comparison with transurethral resection of prostate (TURP) and open prostatectomy (OP).
Methods: Between January 2017 and January 2018, we prospectively enrolled 151 men who underwent HoLEP, TURP or OP at tertiary Italian center, due to bladder outflow obstruction symptoms. Patients with prostate volume ≤ 70 cc and those with prostate volume > 70 cc were scheduled for TURP or HoLEP and OP or HoLEP, respectively. Intraoperative and early post-operative functional outcomes were recorded up to 6 months follow up. Cost analysis was carried out considering direct costs (operating room [OR] utilization costs, nurse, surgeons and anesthesiologists’ costs, OR disposable products costs and OR products sterilization costs), indirect costs (hospital stay costs and diagnostics costs) and global costs as sum of both direct and indirect plus general costs related to hospitalization. Cost analysis was performed comparing patients referred to TURP and HoLEP with prostate volume ≤ 70 cc and men underwent OP and HoLEP with prostate volume > 70 cc respectively.
Results: Overall, 53 (35.1%), 51 (33.7%) and 47 (31.1%) were scheduled to HoLEP, TURP and OP, respectively. Both TURP, HoLEP and OP proved to effectively improve urinary symptoms related to BPE. Considering patients with prostate volume ≤ 70 cc, median global cost of HoLEP was similar to median global cost of TURP (2151.69 € vs. 2185.61 €, respectively; p = 0.61). Considering patients with prostate volume > 70 cc, median global cost of HoLEP was found to be significantly lower than median global cost of OP (2174.15 € vs. 4064.97 €, respectively; p ≤ 0.001).
Conclusions: Global costs of HoLEP are comparable to those of TURP, offering a cost saving of only 11.4 € in favor of HoLEP. Conversely, HoLEP proved to be a strong competitor of OP because of significant global cost sparing amounting to 1890.82 € in favor of HoLEP.
|
topic |
HoLEP; Xost analysis; TURP; Open prostatectomy; Prostatic enlargement |
url |
https://www.pagepressjournals.org/index.php/aiua/article/view/8117 |
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doaj-73406f2ecf9e4ad59ba76fe1b3b4dd412020-11-25T03:10:09ZengPAGEPress PublicationsArchivio Italiano di Urologia e Andrologia1124-35622282-41972020-06-0192210.4081/aiua.2020.2.82Holmium laser prostatectomy in a tertiary Italian center: A prospective cost analysis in comparison with bipolar TURP and open prostatectomyRiccardo Schiavina0Lorenzo Bianchi1Marco Giampaoli2Marco Borghesi3Hussam Dababneh4Francesco Chessa5Cristian Pultrone6Andrea Angiolini7Umberto Barbaresi8Matteo Cevenini9Fabio Manferrari10Alessandro Bertaccini11Angelo Porreca12Eugenio Brunocilla13Department of Urology, University of Bologna; Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Cardio-Nephro-Thoracic Sciences Doctorate, University of Bologna, BolognaDepartment of Urology, University of Bologna; Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Cardio-Nephro-Thoracic Sciences Doctorate, University of Bologna, BolognaDepartment of Urology, Abano Terme Hospital, PaduaDepartment of Urology, University of Bologna; Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Cardio-Nephro-Thoracic Sciences Doctorate, University of Bologna, BolognaDepartment of Urology, University of Bologna; Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Cardio-Nephro-Thoracic Sciences Doctorate, University of Bologna, BolognaDepartment of Urology, University of Bologna; Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Cardio-Nephro-Thoracic Sciences Doctorate, University of Bologna, BolognaDepartment of Urology, University of Bologna; Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Cardio-Nephro-Thoracic Sciences Doctorate, University of Bologna, BolognaDepartment of Urology, University of Bologna, BolognaDepartment of Urology, University of Bologna, BolognaDepartment of Urology, University of Bologna, BolognaDepartment of Urology, University of Bologna; Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Cardio-Nephro-Thoracic Sciences Doctorate, University of Bologna, BolognaDepartment of Urology, University of Bologna; Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Cardio-Nephro-Thoracic Sciences Doctorate, University of Bologna, BolognaDepartment of Urology, Abano Terme Hospital, PaduaDepartment of Urology, University of Bologna; Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Cardio-Nephro-Thoracic Sciences Doctorate, University of Bologna, Bologna Objective: To assess the economic impact of Holmium laser enucleation of prostate (HoLEP) in comparison with transurethral resection of prostate (TURP) and open prostatectomy (OP). Methods: Between January 2017 and January 2018, we prospectively enrolled 151 men who underwent HoLEP, TURP or OP at tertiary Italian center, due to bladder outflow obstruction symptoms. Patients with prostate volume ≤ 70 cc and those with prostate volume > 70 cc were scheduled for TURP or HoLEP and OP or HoLEP, respectively. Intraoperative and early post-operative functional outcomes were recorded up to 6 months follow up. Cost analysis was carried out considering direct costs (operating room [OR] utilization costs, nurse, surgeons and anesthesiologists’ costs, OR disposable products costs and OR products sterilization costs), indirect costs (hospital stay costs and diagnostics costs) and global costs as sum of both direct and indirect plus general costs related to hospitalization. Cost analysis was performed comparing patients referred to TURP and HoLEP with prostate volume ≤ 70 cc and men underwent OP and HoLEP with prostate volume > 70 cc respectively. Results: Overall, 53 (35.1%), 51 (33.7%) and 47 (31.1%) were scheduled to HoLEP, TURP and OP, respectively. Both TURP, HoLEP and OP proved to effectively improve urinary symptoms related to BPE. Considering patients with prostate volume ≤ 70 cc, median global cost of HoLEP was similar to median global cost of TURP (2151.69 € vs. 2185.61 €, respectively; p = 0.61). Considering patients with prostate volume > 70 cc, median global cost of HoLEP was found to be significantly lower than median global cost of OP (2174.15 € vs. 4064.97 €, respectively; p ≤ 0.001). Conclusions: Global costs of HoLEP are comparable to those of TURP, offering a cost saving of only 11.4 € in favor of HoLEP. Conversely, HoLEP proved to be a strong competitor of OP because of significant global cost sparing amounting to 1890.82 € in favor of HoLEP. https://www.pagepressjournals.org/index.php/aiua/article/view/8117HoLEP; Xost analysis; TURP; Open prostatectomy; Prostatic enlargement |