2098 TRENDS IN SURGICAL MANAGEMENT FOR BENIGN PROSTATIC HYPERPLASIA

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy and New Technology1 Apr 20112098 TRENDS IN SURGICAL MANAGEMENT FOR BENIGN PROSTATIC HYPERPLASIA Nora Lee, Hui Xue, and Lori Lerner Nora LeeNora Lee Boston, MA More articles by this author , Hui XueHui Xue Boston, MA More articles by this author , and Lori LernerLori Lerner Hingham, MA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2294AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Surgical management of benign prostatic hyperplasia (BPH) has changed over the past 15 years with new techniques emerging, such as laser therapy and approaches that can be used with anticoagulation, an increasing issue with modern patients. There has been much debate over which procedures are superior and should replace transurethral resection of the prostate (TURP) and open prostatectomy (OP). This is the first of a 2 part study evaluating BPH surgery and current trends in procedure utilization based on age, location, and type of practice. METHODS A 90-item on-line survey was sent via email by the American Urological Association (AUA), Veterans Administration, Society for Government Service Urologists, and Endourological Society. Data concerning utilization of 12 BPH surgical techniques were analyzed and compared to the surgeons' demographics using categorical data analysis. RESULTS A total of 600 urologists replied with 570 currently performing BPH surgery. The percentages of urologists utilizing the various procedures are: OP at 78% of respondents; monopolar TURP 73%; photoselective vaporization (PVP) 58%; TURis button TURP 24%; bipolar TURP 20%; holmium laser ablation of the prostate (HoLAP) 18%; thulium laser ablation of the prostate 4%; and laparoscopic (LP) and robotic (RP) simple prostatectomy at 1% and 3%. When stratified by urologist age, there are no differences in utilization of monopolar TURP or OP and laser therapies are employed across all age ranges. However, RP is only used by urologists <50 years. There are no differences in types of procedures utilized between AUA sections. Of the respondents, 19% work full time in academics. There are no differences in the types of procedures performed in full time academic versus non-academic settings, except for RP and Button, which are utilized more often in academic settings (RP at 7% vs 2% and button TURP at 28% vs 21%, p=0.02). Frequency of BPH surgery is relatively low with over half doing <50 procedures per year: 1–24/yr = 23.4%; 25–49/yr = 32.1%; 50–74/yr = 22.5%; >75/yr = 22%. CONCLUSIONS Change in technology has led urologists to change their approach to BPH surgical treatment. OP and monopolar TURP are still the procedures utilized by most urologists, however, laser therapy has emerged as a commonly used technique. Robotic surgery, while still uncommon for BPH, is used only by younger urologists. Likely what residents learn in residency will impact what they do in practice. However at this time, academic programs do not appear to utilize any different BPH approaches than those used in non academic environments, except robotic surgery and button TURP. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e838 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nora Lee Boston, MA More articles by this author Hui Xue Boston, MA More articles by this author Lori Lerner Hingham, MA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...