Cost aspects of transurethral resection of the prostate, contact laser prostatectomy, and electrovaporization.
OBJECTIVE
To compare the costs of transurethral resection of the prostate (TURP), contact laser prostatectomy (CLP), and electrovaporization in men with lower urinary tract symptoms associated with benign prostatic hyperplasia.


METHODS
We conducted a randomized controlled trial that included men with lower urinary tract symptoms who met the criteria of the International Scientific Committee on benign prostatic hyperplasia. Subjective changes were quantified using questionnaires validated by the American Urological Association. The maximal free urinary flow rate was estimated. Morbidity and mortality were registered. These parameters were measured at regular intervals for up to 1 year and once during long-term follow-up. A cost analysis together with a sensitivity analysis was performed on the basis of a follow-up of 12 months.


RESULTS
A total of 50 men were randomized to TURP, 45 to laser treatment, and 46 to electrovaporization. The subjective and objective changes were very similar during the 12 months of follow-up. The costs were highest for CLP (1885 dollars), followed by TURP (1707 dollars), and were lowest for electrovaporization (1489 dollars). However, the length of hospital stay decreased during the trial more for CLP and electrovaporization than for TURP. Recalculations demonstrated almost equal costs for CLP and TURP (1697 dollars and 1643 dollars, respectively) and the lowest costs for electrovaporization (1386 dollars).


CONCLUSIONS
Electrovaporization has a better cost-effectiveness than CLP and TURP in patients with lower urinary tract symptoms associated with benign prostatic hyperplasia. CLP and TURP showed very similar cost-effectiveness ratios.
van Melick
Harm H E
HH
Department of Urology, University Medical Center Utrecht, Utrecht, The Netherlands.
van Venrooij
Ger E P M
GE
van Swol
Christiaan F P
CF
Boon
Tom A
TA
D003362:Cost-Benefit Analysis; D004598:Electrosurgery / Q000191:economics*; D006801:Humans; D053685:Laser Therapy / Q000191:economics*; D008297:Male; D011468:Prostatectomy / Q000191:economics* / Q000379:methods; D011470:Prostatic Hyperplasia / Q000601:surgery*; D012680:Sensitivity and Specificity; D020728:Transurethral Resection of Prostate / Q000191:economics / Q000379:methods