The market for bladder outflow obstruction surgery is currently wide open with new technologies such as Urolift® emerging. One of the key selling points of new technologies is the comparative safety and efficacy compared to traditional techniques such as transurethral resection of prostate (TURP). However, cited figures for complications and long-term re-intervention can often be from older papers which do not reflect contemporary practice. This paper looked at 95,577 cases of patients who underwent TURP, laser vapourisation (LVP), laser enucleation of the prostate (LEP) or open prostatectomy between 2008 and 2013 in Germany. Open prostatectomy was found to have the greatest risk of complications but the lowest re-intervention rate (OR 0.75). LVP had low rates of bleeding (OR 0.57) and transfusion but greater risk of re-intervention (OR 1.43) compared to TURP, while LEP required more intervention for bleeding (OR 1.35). Transfusion rate with TURP was found to be 3.4%, 2% with LVP / LEP and 14% with open prostatectomy. Re-intervention rate was 6% at one year with TURP, 10% with LVP, 5% with LEP and 2% with open prostatectomy. Interestingly, the proportion of those receiving TURP was found to be on the decline which is reflective of an ever-changing market. Figures cited in this paper would be useful when counselling patients. – PR

Morbidity and mortality after surgery for lower urinary tract symptoms: a study of 95,577 cases from a nationwide German health insurance database.
Gilfrich C, Leicht H, Fahlenbrach C, et al.
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Pravisha Ravindra

University Hospitals Leicester NHS Trust.

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