Canadian trend in surgical management of benign prostatic hyperplasia (BPH) and laser therapy from 2007-2008 to 2011-2012

Abstract

Introduction: Clinically benign prostatic hyperplasia (BPH) is classically associated by the progressive development of lower urinary tract symptoms (LUTS). The incidence of bothersome LUTS is associated with age and may vary in patients over 50 years old. In many developing countries with an aging population, BPH associated with LUTS has become a major health issue. To optimize quality of care and control of cost, there is an imperative need to examine the pattern of BPH management. The goal of this study is to capture the Canadian trend in surgical management of BPH and the use of laser therapy during the last 5 years from

Bipolar Vaporization, Resection, and Enucleation Versus Open Prostatectomy: Optimal Treatment Alternatives in Large Prostate Cases?

“…1 On the other hand, large-volume prostates continue to remain a difficult to treat pathology still maintaining the open approach as a standard therapeutic option. 2,3 However, the conventional open prostatectomy (OP) was associated with a substantial morbidity rate imposing the search for more minimally invasive alternatives.…”

Urological resident exposure to transurethral surgical options for BPH management in 2012-2013: A pan-Canadian survey

“…1 TURP remains the dominant form of surgery for BPH in Canada. 2 The fundamental importance of this surgery explains why the Royal College of Physicians and Surgeons of Canada (RCPSC) 3 classifies TURP as a "List A" surgical procedure, wherein "the fully trained resident must be competent to individually perform" the procedure.…”

“…4 In Canada, a similar trend can be observed, characterized by a continuous increase in the use of MISTs albeit at a slower pace; in 2011, TURP still represented more than 90% of all BPH procedures in the country. 2 Most urology residency training programs are based in tertiary care centres and are typically designed to offer exposure to major surgical cases. In this context, and with the increasingly heavy demands of a residency training program, it is possible that BPH surgeries can become relegated as "minor" surgeries with proper exposure lagging behind.…”

Randomized, controlled trial of laser vs. bipolar plasma vaporization treatment of benign prostatic hyperplasia

“…12 While only 7.6% of TUR procedures in 2011 employed minimally invasive techniques, this number doubled from 2007-2011. 11 If this trend continues, we could see TUVP overtake TURP in the next decade. A few groups have shown vaporization to be more cost-effective than TURP, but to date no one has performed a cost comparison of these devices in Canada.…”

“…Surgical management of BPH is common in Canada, with 20 000 TUR procedures performed annually. 11 With an average cost of $3447 per TURP in Canada, even a modest reduction in cost would have substantial financial implications. 12 While only 7.6% of TUR procedures in 2011 employed minimally invasive techniques, this number doubled from 2007-2011.…”