Department of Urology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York.
Department of Health Policy and Research, Weill Cornell Medical College, New York, New York.
J Urol. 2021 Aug;206(2):409-415. doi: 10.1097/JU.0000000000001757. Epub 2021 Apr 1.
Novel minimally invasive therapies like the prostatic urethral lift are among the many endoscopic options for the treatment of benign prostatic enlargement and lower urinary tract symptoms (BPE/LUTS). To further understand the relative uptake, complications and retreatment rates of contemporary endoscopic procedures for BPE/LUTS across diverse practice types, we performed a retrospective study of inpatient and ambulatory surgery encounters in the Premier Healthcare database.
We included men who underwent endoscopic procedures for BPE/LUTS between 2000 and 2018. We determined the utilization of endoscopic therapies for BPE/LUTS, 30-day and 90-day readmission rates, and retreatment rate. Multivariable logistic regression was used to assess the association of procedure type with outcomes for the 3 most commonly performed procedures.
We identified 175,150 men treated with endoscopic surgery for BPE/LUTS. The annual percent utilization of the prostatic urethral lift increased from <1% in 2014 to 10.4% in 2018. Compared to transurethral resection of the prostate and prostate photovaporization, prostatic urethral lift was associated with a lower odds of readmission at 30 (OR 0.58, p <0.01) and 90 (OR 0.55, p <0.01) days and a higher odds of retreatment within 2 years of followup (OR 1.78, p <0.01).
Providers have rapidly adopted prostatic urethral lift which accounted for more than 1 in 10 endoscopic procedures captured for BPE/LUTS in 2018. Men treated with prostatic urethral lift are readmitted less within 30 and 90 days but are more likely to be retreated within 2 years of their index procedure as compared to men treated with transurethral resection of the prostate or prostate photovaporization.
前列腺尿道提升术等新型微创疗法是治疗良性前列腺增生和下尿路症状（BPE/LUTS）的众多内镜选择之一。为了进一步了解不同实践类型中，当代内镜治疗 BPE/LUTS 的相对采用率、并发症和再治疗率，我们对 Premier Healthcare 数据库中的住院和门诊手术进行了回顾性研究。
我们纳入了 2000 年至 2018 年间接受内镜治疗 BPE/LUTS 的男性患者。我们确定了 BPE/LUTS 内镜治疗的利用情况、30 天和 90 天再入院率以及再治疗率。多变量逻辑回归用于评估在最常进行的 3 种手术中，手术类型与结局的关联。
我们确定了 175150 名接受内镜手术治疗 BPE/LUTS 的男性患者。前列腺尿道提升术的年利用率从 2014 年的<1%增加到 2018 年的 10.4%。与经尿道前列腺切除术和前列腺光汽化术相比，前列腺尿道提升术与 30 天（OR 0.58，p<0.01）和 90 天（OR 0.55，p<0.01）再入院的可能性较低相关，并且在随访 2 年内有更高的再治疗可能性（OR 1.78，p<0.01）。
提供者迅速采用了前列腺尿道提升术，2018 年该手术占 BPE/LUTS 内镜治疗的 10%以上。与接受经尿道前列腺切除术或前列腺光汽化术治疗的男性相比，接受前列腺尿道提升术治疗的男性在 30 天和 90 天内再入院的可能性较低，但在索引手术后 2 年内再次治疗的可能性较高。
