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Surgical Treatment for Benign Prostatic Hyperplasia: Holmium Laser Enucleation of the Prostate (HoLEP).
Published on: March 6, 2018
Practice patterns in benign prostatic hyperplasia surgical therapy: the dramatic increase in minimally invasive
Xinhua Yu1, Sean P Elliott, Timothy J Wilt
1Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota 55455, USA. xinhuayu@umn.edu
The Journal of Urology
|May 24, 2008
Summary
Minimally invasive surgery for benign prostatic hyperplasia surged from 1999-2005, replacing traditional transurethral prostatectomy. Racial disparities in minimally invasive surgical treatment access persist, impacting healthcare costs and outcomes.
Area of Science:
- Urology
- Health Services Research
- Geriatric Medicine
Background:
- Benign prostatic hyperplasia (BPH) affects a significant portion of elderly men.
- Surgical interventions are common treatments for symptomatic BPH.
- Transurethral prostatectomy (TURP) has been a traditional surgical approach.
Purpose of the Study:
- To analyze trends in surgical treatments for BPH between 1999 and 2005.
- To compare the adoption rates of transurethral prostatectomy (TURP) versus minimally invasive surgical treatments (MIST) for BPH.
- To examine variations in MIST utilization among elderly Medicare beneficiaries by age, race, and clinical setting.
Main Methods:
- Utilized 100% Medicare carrier files (Part B physician claims) for BPH surgeries.
- Calculated annual age-specific and age-adjusted procedure rates by race.
- Determined the percentage of procedures performed in various clinical settings.
Main Results:
- Total BPH procedures increased by 44% from 1999 to 2005.
- Minimally invasive surgical treatments (MIST) saw a 529% increase in volume and 439% increase in rates.
- By 2005, MIST constituted 57% of BPH surgeries, while TURP decreased to 39%.
- Significant differences in MIST utilization were observed across racial groups, with Black beneficiaries less likely to receive MIST than Whites.
Conclusions:
- The shift towards MIST, coupled with a decline in TURP, significantly altered BPH surgical patterns.
- Persistent disparities in MIST access among different age and racial groups warrant further investigation.
- The changing landscape of BPH surgical treatment likely has substantial implications for healthcare expenditures and patient outcomes.