A real-world evidence study of interhospital variability in the surgical treatment of patients with benign prostatic hyperplasia: the REVALURO study.

Autor: Iván PM; Consorcio Hospital General Universitario, Av. de les Tres Creus, 2, Valencia, Spain., Alberto BA; Hospital Universitario y Politécnico La Fe, Av. de Fernando Abril Martorell, 106, Valencia, Spain., Lluís PC; Hospital Clínic de Barcelona, C. de Villarroel, 170, Barcelona, Spain., Maurizio D; Hospital Clínic de Barcelona, C. de Villarroel, 170, Barcelona, Spain., Jose Luís GB; Hospital Universitario Marqués de Valdecilla, Av. De Valdecilla, Santander, Spain., Francisco Javier VP; Hospital Universitario Virgen de las Nieves, Av. De las Fuerzas Armadas, 2, Granada, Spain., Almudena SB; Hospital Universitario Virgen de las Nieves, Av. De las Fuerzas Armadas, 2, Granada, Spain., Jaime GH; Hospital Universitario Marqués de Valdecilla, Av. De Valdecilla, Santander, Spain., Esperanza TM; Health Economics and Market Access, Boston Scientific Inc., Madrid, Spain., Pablo BA; Health Economics and Market Access, Boston Scientific Inc., Madrid, Spain., Gabriela OA; Health Outcomes Performance Ecosystem for Sustainability (HOPES), Valencia, Spain., Manuel GB; Pharmacoeconomics and Outcomes Research Iberia (PORIB), Paseo Joaquín Rodrigo 4 - Letter I, Madrid, Spain., Miguel Ángel C; Pharmacoeconomics and Outcomes Research Iberia (PORIB), Paseo Joaquín Rodrigo 4 - Letter I, Madrid, Spain., Alberto CG; Pharmacoeconomics and Outcomes Research Iberia (PORIB), Paseo Joaquín Rodrigo 4 - Letter I, Madrid, Spain. adelacuadra@porib.com., Emilio LA; Consorcio Hospital General Universitario, Av. de les Tres Creus, 2, Valencia, Spain.
Jazyk: angličtina
Zdroj: International urology and nephrology [Int Urol Nephrol] 2024 Oct 29. Date of Electronic Publication: 2024 Oct 29.
DOI: 10.1007/s11255-024-04239-7
Abstrakt: Purpose: Lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) is a growing condition in males associated with a high clinical, economic and humanistic burden. Several surgical techniques are available for the treatment of LUTS/BPH; thus, the aim of this study was to describe and explore the variability in the use of surgical procedures among Spanish hospitals.
Methods: The REVALURO was a retrospective, observational study conducted by collecting data from the clinical records of patients with LUTS/BPH aged ≥ 35 years, from 5 national reference hospitals, who were surgically treated between 2018 and 2022.
Results: Among the 3038 patients who underwent 3084 surgeries, 66% were invasive (2018: 57.5%, 2022: 71.5%), 22% were minimally invasive (MISTs) (2018: 20.7%, 2022: 20.2%) and 12% were highly invasive (2018: 21.8%, 2022: 8.4%). A total of 22.4% of patients' complications, with a maximum incidence of 28.6% (open prostatectomy) and a minimum 0.8% (water vapor thermal therapy (WVTT)] (p < 0.001). The reintervention rate was 1.5% over the study period. The median length of hospital stay after surgery increased from 0 days (interquartile range [IQR]: 0) with WVTT to 5 days (IQR: 4-8) with open prostatectomy (p < 0.001).
Conclusion: Trends in surgical treatment showed that the use of invasive techniques increased, while the use of highly invasive techniques decreased, and the use of MISTs remained constant. However, given the heterogeneity among hospitals, national clinical guidelines and recommendations are needed to guide the decision on which technique should be used and to homogenize the criteria.
(© 2024. The Author(s).)
Databáze: MEDLINE
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