在BPH手术后,再治疗率和手术后并发症高于预期:美国医疗保健索赔和利用率研究
Steve Kaplan1, Ronald P Kaufman2, Thomas Mueller3
1Mount Sinai, New York, NY, USA. Steven.Kaplan@MountSinai.org.
Prostate cancer and prostatic diseases
|October 26, 2023
概括
良性前列腺增生 (BPH) 手术的结果各不相同,重复治疗率相似,但在不同程序中存在不同的并发症风险. 在一年内,每20名患者中就有1人可能需要重新治疗,而有些人可能会面临并发症.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 手术结果研究研究.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 良性前列腺增生症 (BPH) 影响着相当一部分老年男性.
- 了解BPH治疗的比较风险和益处对于共享决策至关重要.
研究的目的:
- 为了比较四种常见的BPH手术程序的现实世界结果.
- 为了评估手术后的一到五年内再治疗率和手术并发症.
主要方法:
- 使用美国医疗保险和商业索赔数据 (2015-2021) 的回顾性队列研究.
- 包括接受过尿道切除前列腺 (TURP),前列腺光选择性蒸发 (PVP),前列腺尿道升降 (PUL) 或水蒸气热疗法 (WVTT) 的男性.
- 使用CPT和ICD代码评估再治疗和并发症率,并根据年龄和并发症进行调整.
主要成果:
- 一年后,PUL的并发症率最低 (15%),而WVTT的并发症率最高 (26%).
- 在所有手术中,1年后的再治疗率相似 (5.3%-6.2%).
- 在5年后,TURP的再治疗率最低 (7.0%).
结论:
- 尽管在第一年内重复治疗率相似,但BPH手术治疗与不同的并发症风险有关.
- 大约5%的患者可能需要在一年内重新治疗,无论选择哪种外科手术.
- 显著比例的患者,在某些技术中高达25%,可能会出现需要进一步治疗的并发症.
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