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Photoselective vaporization of the prostate. Review of cost implementation to BPH treatment

Abstract

Effective treatment of benign prostatic hyperplasia (BPH) involves not only a reduction of symptom scores and the prevention of serious complications, but also an improvement in overall patient's quality of life and cost effectiveness. There is a paucity of data regarding cost effectiveness when the pharmacologic, the minimally invasive and the surgical treatments of BPH are compared. The potassium-titanyl-phosphate laser prostatectomy seems to be a safe and effective treatment option both in the short and in the long-term run. Preliminary results indicate that photoselective vaporization of the prostate is also a cost-effective method when compared to different minimally invasive treatments and to the transurethral prostatectomy.

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References

  1. Mebust W, Holtgrewe H, Cockett A, Peters P . Writing committee, the American urological association. Transurethral prostatectomy: Immediate and postoperative complications. Cooperative study of 13 participating institutions evaluating 3885 patients. J Urol 1989; 141: 243–247.

    Article  CAS  PubMed  Google Scholar 

  2. Malek R, Kuntzman R, Barrett D . Photoselective potassium-titanyl-phosphate laser vaporization of the benign obstructive prostate: Observations on long term outcomes. J Urol 2005; 174: 1344–1348.

    Article  PubMed  Google Scholar 

  3. Bouchier D, Anderson P, Van Appledorn S, Bugeja P, Costello A . KTP laser versus transurethral resection: early results of a randomized trial. J Endourol 2006; 20: 580–585.

    Article  Google Scholar 

  4. Bachmann A, Schurch L, Ruszat R, Wyler SF, Seifert H, Muller A et al. Photoselective vaporization of the prostate: the basal experience after 108 procedures. Eur Urol 2005; 47: 798–804.

    Article  PubMed  Google Scholar 

  5. Te A, Malloy T, Stein B, Ulchaker J, Nseyo U, Hai M et al. Photoselective vaporization of the prostate for the treatment of benign Prostatic Hyperplasia: 12 month results from the first United States multicenter prospective Study. J Urol 2004; 172: 1404–1408.

    Article  PubMed  Google Scholar 

  6. Sarica K, Alkan E, Luleci H, Tasci AI . Photoselective vaporization of the enlarged prostate with KTP laser: long-term results in 240 patients. J Endourol 2005; 19: 1199–1202.

    Article  PubMed  Google Scholar 

  7. Sandhu JS, Ng C, Vanderbrink BA, Egan C, Kaplan SA, Te AE . High-power potassium-titanyl-phosphate photoselective laser vaporization of prostate for treatment of benign prostatic hyperplasia in men with large prostates. Urology 2004; 64: 1155–1159.

    Article  PubMed  Google Scholar 

  8. Ruszat R, Wyler S, Forster T, Reich O, Stief CG, Gasser TC et al. Safety and effectiveness of photoselective vaporization of the prostate (PVP) in patients on ongoing oral anticoagulation. Eur Urol 2006 [E-pub ahead of print, 18 August].

  9. Taub DA, Wei JT . The economics of benign prostatic hyperplasia and lower urinary tract symptoms in the United States. Curr Urol Rep 2006; 7: 272–281.

    Article  PubMed  Google Scholar 

  10. Stoevelaar HJ, McDonnell J . Changing therapeutic regimens in benign prostatic hyperplasia. Pharmacoeconomics 2001; 19: 131–153.

    Article  CAS  PubMed  Google Scholar 

  11. Platz EA, Smit E, Curhan GC, Nyberg LM, Giovannucci E . Prevalence of racial/ethnic variation in lower urinary tract symptoms noncancer prostate surgery in US men. Urology 2002; 59: 877–883.

    Article  PubMed  Google Scholar 

  12. Sarma AV, Wei JT, Jacobson DJ, Dunn RL, Roberto RO, Girman CJ et al. Comparison of lower urinary tract symptom severity and associated bother between community-dwelling black and white men: the Olmsted County Study and the Flint Men's Health Study. Urology 2003; 61: 1086–1091.

    Article  PubMed  Google Scholar 

  13. Jacobsen SJ, Girman CJ, Guess HA, Oesterling JE, Lieber MM . New diagnostic and treatment guidelines for benign prostatic hyperplasia. Potential impact in the United States. Arch Intern Med 1995; 155: 477–481.

    Article  CAS  PubMed  Google Scholar 

  14. Jacobsen SJ, Jacobson DJ, Girman CJ, Roberts RO, Rhodes T, Guess HA et al. Treatment for benign prostatic hyperplasia among community-dwelling men: The Olmsted County Study of urinary symptoms and health status. J Urol 1999; 162: 1301–1306.

    Article  CAS  PubMed  Google Scholar 

  15. Goluboff ET, Olsson CA . Urologists on a tightrope: coping with a changing economy. J Urol 1994; 151: 1–4.

    Article  CAS  PubMed  Google Scholar 

  16. Wei JT, Jacobsen SJ, Calhoun E . Benign pcostatic hyperplasia. In: Litwin MS, Saigal CS (eds). Urologic Diseases in America: Interim Compendium. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, US Government Publishing Office: Washington, DC, 2004, pp 43–70.

    Google Scholar 

  17. Lowe FC, McDaniel RL, Chmiel JJ, Hillman AL . Economic modeling to assess the costs of treatment with finnsteride, terazosin, and transurcthral resection of the prostate for men with moderate to severe symptoms of benign prostatic hyperplasia. Urology 1995; 46: 477–483.

    Article  CAS  PubMed  Google Scholar 

  18. Cockrum PC, Finder SF, Ries AJ, Potyk RP . A pharmacoeconomic analysis of patients with symptoms of benign prostatic hyperplasia. Pharmacoeconomics 1997; 11: 550–565.

    Article  CAS  PubMed  Google Scholar 

  19. Chirikos TN, Sanford E . Cost consequences of surveillance, medical management or surgery for benign prostatic hyperplasia. J Urol 1996; 155: 1311–1316.

    Article  CAS  PubMed  Google Scholar 

  20. Baladi JF, Menon D, Otten N . An economic evaluation of finasteride for treatment of benign prostatic hyperplasia. Pharmacoeconomics 1996; 9: 443–454.

    Article  CAS  PubMed  Google Scholar 

  21. Blute M, Ackerman SJ, Rein AL, Beusterien K, Sullivan EM, Tanio CP et al. Cost effectiveness? Of microwave thermotherapy in patients with benign prostatic hyperplasia: part II. Results. Urology 2000; 56: 981–987.

    Article  CAS  PubMed  Google Scholar 

  22. Noble SM, Coast J, Brooks S, Neal DE, Abrams P, Peters DJ et al. Transurethral prostate resection, noncontact laser therapy or conservative management in men with symptoms of benign prostatic enlargement? An economic evaluation. J Urol 2002; 168: 2476–2482.

    Article  PubMed  Google Scholar 

  23. Norby B, Nielsen HV, Frimodt-Moller PC . Transurethral interstitial laser coagulation of the prostate and transurethral microwave thermotherapy vs transurethral resection or incision of the prostate: results of a randomized, controlled study in patients with symptomatic benign prostatic hyperplasia. BJU Int 2002; 90: 853–862.

    Article  CAS  PubMed  Google Scholar 

  24. Walden M, Acosta S, Carlsson P, Pettersson SC . A cost-effectiveness analysis of transurethral resection of the prostate and transurethral microwave thermotherapy for treatment of benign prostatic hyperplasia: two-year follow-up. Scand J Urol Nephrol l 998; 32: 204–210.

    Google Scholar 

  25. Wickware P . BPH: conservative treatment equals extravagant costs [letter]. Urology Times 2000; 28: 22.

    Google Scholar 

  26. DiSantostefano RL, Biddle AK, Lavelle JP . The long-term cost effectiveness of treatments for benign prostatic hyperplasia. Pharmacoeconomics 2006; 24: 171–191.

    Article  PubMed  Google Scholar 

  27. McDonald H, Hux M, Brisson M, Bernard L, Nickel JC . An economic evaluation of doxazosin, finasteride and combination therapy in the treatment of benign prostatic hyperplasia. Can J Urol 2004; 11: 2327–2340.

    PubMed  Google Scholar 

  28. McDonnell J, Busschbach JJ, Kok E, van Exel J, Stolk E, Koopmanschap M et al. Lower urinary tract symptoms suggestive of benign prostatic obstruction: triumph. Health-economical analysis. Eur Urol 2001; 39 (Suppl 3): 37–41.

    Article  PubMed  Google Scholar 

  29. Jepsen JV, Bruskewitz RC . Surgical and nonsurgical invasive treatment of benign prostatic hyperplasia. Drugs Today (Barc) 1998; 34: 353–360.

    Article  CAS  Google Scholar 

  30. McConnell JD, Barry MJ, Bruskewitz RC . Benign prostatic hyperplasia: diagnosis and treatment. Clinical Practice Guideline, Number 8, AHCPR Publication No. 94-0582. Agency for Health Care Policy and Research, Public Health Service, US Department of Health and Human Services: Rockville, MD, 1994.

    Google Scholar 

  31. Black L, Naslund MJ, Gilbert Jr TD, Davis EA, Ollendorf DA . An examination of treatment patterns and costs of care among patients with benign prostatic hyperplasia. Am J Manag Care 2006; 12 (Suppl 4): s99–s110.

    PubMed  Google Scholar 

  32. Manyak MJ, Santangelo K, Hahn J, Kaufman R, Carleton T, Hua XC et al. Cost effectiveness of treatment for benign prostatic hyperplasia: an economic model for comparison of medical, minimally invasive, and surgical therapy. J Endourol 2002; 16: 51–56.

    Article  PubMed  Google Scholar 

  33. Ravery V . Transurethral microwave thermotherapy versus transurethral resection of prostate. Tech Urol 2000; 6: 267–270.

    CAS  PubMed  Google Scholar 

  34. Kobelt G, Spangberg A, Mattiasson A . The cost of feedback microwave thermotherapy compared with transurethral resection of the prostate for treating benign prostatic hyperplasia. BJU Int 2004; 93: 543–548.

    Article  CAS  PubMed  Google Scholar 

  35. Denis L, Griffiths K, Khoury S (eds). Proceedings of the 4th International Consultation on Benign Prostatic Hyperplasia (BPH) 1997. Plymouth: Health Publication Ltd: Paris, 1998.

  36. Kuntz RM . Current role of lasers in the treatment of benign prostatic hyperplasia (BPH). Eur Urol 2006; 49: 961–969.

    Article  PubMed  Google Scholar 

  37. Mottet N, Anidjar M, Bourdon O, Louis JF, Telliac P, Costa P et al. Randomized comparison of transurethral electroresection and holmium:YAG laser vaporization for symptomatic benign prostatic hyperplasia. J Endourol 1999; 13: 127–130.

    Article  CAS  PubMed  Google Scholar 

  38. Gilling PJ, Mackey M, Cressell M, Kennett K, Kabalin JN, Fraundorfer MR . Holmium laser versus transurethral resection of the prostate: a randomized prospective trial with one year of follow-up. J Urol 1999; 162: 1640–1644.

    Article  CAS  PubMed  Google Scholar 

  39. Gilling PJ, Kennett K, Fraundorfer MR . Holmium laser resection v transurethral resection of the prostate: results of a randomized trial with 2 years of follow-up. J Endourol 2000; 114: 757–760.

    Article  Google Scholar 

  40. Westenberg A, Gilling PJ, Kennett K, Frampton C, Fraundorfer MR . Holmium laser resection of the prostate versus transurethral resection of the prostate: results of a randomized trial with 4-year minimum long-term follow-up. J Urol 2004; 172: 616–619.

    Article  PubMed  Google Scholar 

  41. Tan AHH, Gilling PJ, Kennett K, Frampton C, Westenberg A, Fraundorfer MR . A randomized trial comparing holmium laser enucleation of the prostate with transurethral resection of the prostate for the treatment of bladder outlet obstruction secondary to benign prostatic hyperplasia in large glands (40–200 g). J Urol 2003; 170: 1270–1274.

    Article  CAS  PubMed  Google Scholar 

  42. Montorsi F, Naspro R, Salonia A, Suardi N, Briganti A, Zanoni M et al. Holmium laser enucleation versus transurethral resection of the prostate: results from a two center, prospective randomized trial in patients with obstructive benign prostatic hyperplasia. J Urol 2004; 172: 1926–1929.

    Article  PubMed  Google Scholar 

  43. Kuntz RM, Ahayai S, Lehrich K, Fayad A . Transurethral holmium laser enucleation of the prostate versus transurethral electrocautery resection of the prostate: a randomized prospective trial in 200 patients. J Urol 2004; 172: 1012–1016.

    Article  PubMed  Google Scholar 

  44. Kuntz RM, Ahyai S, Lehrich K . Transurethral holmium laser enucleation of the prostate (HoLEP) compared with TURP: 3 years follow-up results of a randomized clinical trial in 200 patients. Proc SPIE 2006; 6078: 10.

    Google Scholar 

  45. Kuntz RM, Lehrich K . Transurethral holmium laser enucleation versus transvesical open enucleation for prostate adenoma greater than 100 gm: a randomized prospective trial of 120 patients. J Urol 2002; 168: 1465–1469.

    Article  PubMed  Google Scholar 

  46. Kuntz RM, Lehrich K, Ahyai S . Transurethral holmium laser enucleation of the prostate: 18-months-follow-up of a randomized study. J Endourol 2004; 118: 189–191.

    Article  Google Scholar 

  47. Kuntz RM, Ahyai S, Lehrich K . Transurethral holmium laser enucleation of the prostate compared with transvesical open prostatectomy: 3 years follow-up of a randomized trial in. Proc SPIE 2006; 6078: 11.

    Google Scholar 

  48. Fraundorfer MR, Gilling PJ, Kennett KM, Dunton NG . Holmium laser resection of the prostate is more cost effective than transurethral resection of the prostate: results of a randomized, prospective study. Urology 2001; 57: 454–458.

    Article  CAS  PubMed  Google Scholar 

  49. Salonia A, Suardi N, Naspro R, Mazzoccoli B, Zanni G, Gallina A et al. Holmium laser enucleation versus open prostatectomy for benign prostatic hyperplasia: an inpatient cost analysis. Urology 2006; 68: 302–306.

    Article  PubMed  Google Scholar 

  50. Te AE . The development of laser prostatectomy. BJU Int 2004; 93: 262–265.

    Article  CAS  PubMed  Google Scholar 

  51. Sulser T, Reich O, Wyler S, Ruszat R, Casella R, Hofstetter A et al. Photoselective KTP vaporization of the prostate: first experienceswith 65 procedures. J Endourol 2004; 18: 976–981.

    Article  PubMed  Google Scholar 

  52. Volkan T, Ihsan TA, Yilmaz O, Emin O, Selcuk S, Koray K et al. Short term outcomes of high power (80W) potassium-titanyl-phosphate laser vaporization of the prostate. Eur Urol 2005; 48: 608–613.

    Article  PubMed  Google Scholar 

  53. Reich O, Bachmann A, Siebels M, Hofstetter A, Stief C, Susler T . High-power (80W) potassium-titanyl-phosphate photoselective laser vaporization of the prostate in 66 high risk patients. J Urol 2005; 173: 158–160.

    Article  PubMed  Google Scholar 

  54. Bouchier-Hayes DM, Anderson P, Van Appledom S, Bugeja P, Costello AJ . KTP laser versus transurethral resection: Early results of a randomized trial. J Endourol 2006; 20: 580–585.

    Article  PubMed  Google Scholar 

  55. Bahmann A, Schurch L, Ruszat R, Wyler SF, Seifert HH, Muller A et al. Photoselective vaporization (PVP) versus transurethral resection of the prostate (TURP): a prospective bi-centre study of perioperative morbidity and early functional outcome. Eur Urol 2005; 48: 965–971.

    Article  Google Scholar 

  56. Stovsky MD, Griffiths RI, Duff SB . A clinical outcomes and cost analysis comparing photoselective vaporization of the prostate to alternative minimally invasive therapies and transurethral prostate resection for the treatment of benign prostatic hyperplasia. J Urol 2006; 176: 1500–1506.

    Article  PubMed  Google Scholar 

  57. Ruszat R, Susler T, Seifert H, Wyler S, Forster T, Leippold T et al. Photoselective vaporization (PVP) vs Transurethral electroresection of the prostate (TURP): a comparative cost analysis. EAU Congress Paris Abstract No 996 Eur Urol Suppl 2006; 5: 271.

    Google Scholar 

  58. Mc Allister WJ, Gilling PJ . Vaporization of the prostate. Curr Opin Urol 2004; 14: 31–34.

    Article  Google Scholar 

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Alivizatos, G., Skolarikos, A. Photoselective vaporization of the prostate. Review of cost implementation to BPH treatment. Prostate Cancer Prostatic Dis 10 (Suppl 1), S15–S20 (2007). https://doi.org/10.1038/sj.pcan.4500950

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