Quality and cost between transcervical and transurethral prostatectomy.

Area of Science:

• Urology
• Surgical Techniques
• Health Economics

Background:

• Transurethral resection of the prostate (TURP) is a common procedure for benign prostatic hyperplasia but has significant drawbacks.
• High postoperative morbidity (up to 50%) and re-operation rates (25% in 8 years) impact quality of life and increase costs.
• Incomplete resection in TURP, with only ~40% of tissue removed, contributes to its limitations.

Purpose of the Study:

• To evaluate the quality of life and total cost-effectiveness of Transcervical Prostatectomy (TCP) compared to TURP.
• To assess the morbidity and mortality rates associated with both surgical techniques.
• To analyze the cumulative costs, including complications, for both TURP and TCP.

Main Methods:

• Comparative analysis of Transcervical Prostatectomy (TCP) and Transurethral Resection of the Prostate (TURP) outcomes.
• Evaluation of postoperative morbidity, mortality, catheterization duration, and hospital stay.
• Detailed cost analysis, including primary operation expenses and cumulative costs considering complications.

Main Results:

• TCP involves total enucleation of the prostate gland, unlike the partial resection of TURP.
• TCP shows significantly lower postoperative morbidity (<5%) and mortality (<1%) compared to TURP.
• TCP demonstrates superior cost-effectiveness, with cumulative costs of £2580 vs. £4333 for TURP, and potentially much higher for TURP when all patient-borne expenses are included.

Conclusions:

• Transcervical Prostatectomy (TCP) is favorable compared to TURP in terms of morbidity, re-operation rates, and cost-effectiveness.
• TCP offers a more complete gland removal, leading to better long-term outcomes.
• The primary advantage of TCP over TURP lies in its overall improved patient outcomes and economic benefits, despite a minor difference in the abdominal skin incision.