Trends and Perioperative Outcomes of Surgical Treatments for Benign Prostatic Hyperplasia in Germany: Results from the GRAND Study

IF 5.6 2区医学 Q1 UROLOGY & NEPHROLOGY European urology focus Pub Date : 2025-05-01 DOI:10.1016/j.euf.2025.01.002

Julian Marcon , Patrick Keller , Nikolaos Pyrgidis, Michael Atzler, Marc Kidess, Melanie Götz, Jan-Friedrich Jokisch, Michael Chaloupka, Christian G. Stief, Gerald B. Schulz, Philipp Weinhold

{"title":"Trends and Perioperative Outcomes of Surgical Treatments for Benign Prostatic Hyperplasia in Germany: Results from the GRAND Study","authors":"Julian Marcon , Patrick Keller , Nikolaos Pyrgidis, Michael Atzler, Marc Kidess, Melanie Götz, Jan-Friedrich Jokisch, Michael Chaloupka, Christian G. Stief, Gerald B. Schulz, Philipp Weinhold","doi":"10.1016/j.euf.2025.01.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and objective</h3><div>Real-world data exploring the perioperative outcomes of different surgical treatments for benign prostatic hyperplasia (BPH) are lacking. We aimed to assess the trends of BPH surgeries and compare their perioperative outcomes.</div></div><div><h3>Methods</h3><div>We used the GeRmAn Nationwide inpatient Data (GRAND), provided by the Research Data Center of the Federal Bureau of Statistics (2005–2022), and performed multiple patient-level analyses.</div></div><div><h3>Key findings and limitations</h3><div>Our study included 1 355 845 surgical treatments for BPH. Of these, 1 084 650 (79.9%) were transurethral resection of the prostate (TURP), 90 735 (6.9%) simple prostatectomy, 64 325 (4.7%) holmium laser enucleation of the prostate (HoLEP), 58 406 (4.3%) laser vaporization, 25 747 (1.9%) electrovaporization, 15 241 (1.1%) thulium laser enucleation of the prostate (ThuLEP), 7873 (0.58%) prostate incision, 3298 (0.24%) water ablation, 2724 (0.2%) water vapor thermal therapy, 1235 (0.09%) prostate stent, 1100 (0.08%) transurethral needle ablation of the prostate, and 511 (0.03%) prostatic urethral lift. The use of HoLEP, ThuLEP, water ablation, and water vapor thermal therapy has increased exponentially in the last years. After adjusting for the major risk factors in the multivariate regression analysis, simple prostatectomy was associated with the worst outcomes compared with TURP, followed by electrovaporization. On the contrary, HoLEP and ThuLEP were associated with favorable outcomes, in terms of sepsis, ureteral stent placement, transfusion, admission to the intensive care unit, hospital stay, and mortality, compared with TURP. Similarly, minimally invasive surgical therapies were associated with high safety compared with TURP. Nevertheless, our findings are based on retrospective billing data and are prone to a selection bias.</div></div><div><h3>Conclusions and clinical implications</h3><div>The trends and perioperative outcomes of BPH surgery should be taken into consideration to improve clinical decision-making and patient outcomes.</div></div>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":"11 3","pages":"Pages 463-470"},"PeriodicalIF":5.6000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European urology focus","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2405456925000021","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background and objective

Real-world data exploring the perioperative outcomes of different surgical treatments for benign prostatic hyperplasia (BPH) are lacking. We aimed to assess the trends of BPH surgeries and compare their perioperative outcomes.

Methods

We used the GeRmAn Nationwide inpatient Data (GRAND), provided by the Research Data Center of the Federal Bureau of Statistics (2005–2022), and performed multiple patient-level analyses.

Key findings and limitations

Our study included 1 355 845 surgical treatments for BPH. Of these, 1 084 650 (79.9%) were transurethral resection of the prostate (TURP), 90 735 (6.9%) simple prostatectomy, 64 325 (4.7%) holmium laser enucleation of the prostate (HoLEP), 58 406 (4.3%) laser vaporization, 25 747 (1.9%) electrovaporization, 15 241 (1.1%) thulium laser enucleation of the prostate (ThuLEP), 7873 (0.58%) prostate incision, 3298 (0.24%) water ablation, 2724 (0.2%) water vapor thermal therapy, 1235 (0.09%) prostate stent, 1100 (0.08%) transurethral needle ablation of the prostate, and 511 (0.03%) prostatic urethral lift. The use of HoLEP, ThuLEP, water ablation, and water vapor thermal therapy has increased exponentially in the last years. After adjusting for the major risk factors in the multivariate regression analysis, simple prostatectomy was associated with the worst outcomes compared with TURP, followed by electrovaporization. On the contrary, HoLEP and ThuLEP were associated with favorable outcomes, in terms of sepsis, ureteral stent placement, transfusion, admission to the intensive care unit, hospital stay, and mortality, compared with TURP. Similarly, minimally invasive surgical therapies were associated with high safety compared with TURP. Nevertheless, our findings are based on retrospective billing data and are prone to a selection bias.

Conclusions and clinical implications

The trends and perioperative outcomes of BPH surgery should be taken into consideration to improve clinical decision-making and patient outcomes.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

德国良性前列腺增生手术治疗的趋势和围手术期结果：GRAND研究的结果。

背景与目的：探讨不同手术治疗良性前列腺增生（BPH）围手术期预后的真实数据缺乏。我们的目的是评估前列腺增生手术的趋势，并比较它们的围手术期结果。方法：我们使用联邦统计局研究数据中心（2005-2022）提供的德国全国住院患者数据（GRAND），并进行了多项患者水平的分析。主要发现和局限性：我们的研究纳入了1 355 845例前列腺增生的手术治疗。其中经尿道前列腺切除术（TURP） 1 084 650例（79.9%），单纯前列腺切除术90 735例（6.9%），钬激光前列腺去核术（HoLEP） 64 325例（4.7%），激光汽化58 406例（4.3%），电汽化25 747例（1.9%），铥激光前列腺去核术（ThuLEP） 15 241例（1.1%），前列腺切开7873例（0.58%），水消融3298例（0.24%），水蒸汽热治疗2724例（0.2%），前列腺支架1235例（0.09%）。经尿道前列腺穿刺消融术1100例（0.08%），前列腺尿道提升术511例（0.03%）。HoLEP、ThuLEP、水消融和水蒸气热疗法的使用在过去几年中呈指数增长。在多因素回归分析中调整了主要危险因素后，与TURP相比，单纯前列腺切除术的预后最差，其次是电汽化。相反，与TURP相比，HoLEP和ThuLEP在败血症、输尿管支架置入术、输血、入住重症监护病房、住院时间和死亡率方面具有良好的预后。同样，与TURP相比，微创手术治疗具有较高的安全性。然而，我们的发现是基于回顾性的账单数据，容易产生选择偏差。结论及临床意义：BPH手术的发展趋势和围手术期预后应予以综合考虑，以改善临床决策和患者预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

European urology focus Medicine-Urology

CiteScore

10.40

自引率

3.70%

发文量

274

审稿时长

23 days

期刊介绍： European Urology Focus is a new sister journal to European Urology and an official publication of the European Association of Urology (EAU). EU Focus will publish original articles, opinion piece editorials and topical reviews on a wide range of urological issues such as oncology, functional urology, reconstructive urology, laparoscopy, robotic surgery, endourology, female urology, andrology, paediatric urology and sexual medicine. The editorial team welcome basic and translational research articles in the field of urological diseases. Authors may be solicited by the Editor directly. All submitted manuscripts will be peer-reviewed by a panel of experts before being considered for publication.