For a study, researchers sought to analyze the literature for cost and cost-effectiveness assessments of surgical treatment options for benign prostatic hypertrophy (BPH) and concomitant LUTS in the United States. TURP provided the best symptom relief, but its expenses were determined by operating room time, equipment, and duration of hospital stay. Other surgical treatment modalities studied, such as transurethral laser ablative, thermal ablative, convective water vapor modalities, and prostatic urethral lift and transabdominal procedures, had higher costs and lower cost-effectiveness inpatient and outpatient settings, with some exceptions. For mild, moderate, and severe BPH, HoLEP and Greenlight PVP showed to be more cost-effective than TURP. On average, convective water vapor ablation, like transurethral microwave/thermal ablative therapy, was less costly per operation than TURP. It did, however, result in lower levels of IPSS symptom improvement. Furthermore, as compared to TURP, prostatic artery embolization showed lower average expenditure and less objective improvement in maximum flow rate, prostate volume reduction, PSA fall, and modest improvement in IPSS subjective outcome measures.

Selection bias, asymmetric patient groups, research aggregation difficulties, and understudied cost factors (such as retreatment costs, long-term durability of symptom alleviation, recuperation time, and job productivity limits) were found as major drawbacks in the study. Nonetheless, the study took crucial steps toward understanding the costs of surgical treatment options for BPH, helping clinicians and policymakers to make better-educated judgments.

Reference:link.springer.com/article/10.1007/s11934-022-01083-z