Photoselective vaporization of the prostate more cost-effective than transurethral resection of the prostate for benign prostatic hyperplasia

September 1, 2011

PVP is beginning to challenge TURP as the gold standard for treatment of BPH.

Key Points

Washington-Transurethral resection of the prostate (TURP) remains the gold-standard treatment for patients with BPH. However, this is being challenged by the development of laser vaporization therapies such as photoselective vaporization of the prostate (PVP), which is the most widely used technology. The cost differential between the traditional TURP and laser vaporization, both of which are currently offered within the Veterans Administration health system, is not insignificant, according to research presented at the AUA annual meeting in Washington.

In a study by VA researchers, the cumulative costs of TURP, including those associated with conducting the procedure, length of stay, care administered during the stay, and postoperative care out to 12 months from surgery was $10,965 compared to $7,401 for laser vaporization procedures, a more than 32% difference.

"Even though we hate to talk about costs in terms of how we treat our veterans, we have to recognize that costs do play a role when we are talking about taxpayer money," first author Daniel Willis, MD, told Urology Times.

Dr. Willis, of the Malcom Randall VA Medical Center, Gainesville, FL, introduced the study by noting that while TURP remains the gold standard, a growing number of studies are showing that PVP produces similar outcomes. In this cost analysis study, it was the length of hospital stay that was the differentiating factor. Patients undergoing TURP were hospitalized for an average of 2.5 days following the procedure compared to 1.3 days for PVP.

A factor that may or may not have weighed on this was that patients undergoing TURP in the VA health system had a statistically significantly higher incidence of comorbid disease. The Charlson comorbidity index scores for TURP patients was 0.59 compared to 0.05 for PVP patients (p<.001)