title: [Comparative analysis of photoselective vaporization of the prostate with the Greenlight laser and open prostatectomy for high volume prostate hypertrophy].
abstract: OBJECTIVE
  Comparative medical economic study between total prostatectomy and laser in the treatment of benign prostatic hyperplasia in patients whose prostate is more than 80g.
  
  
  METHODS
  This study compared data registered retrospectively for the group AVH and prospective data for PVP patients. The patients whose prostate weighed more than 80g by echography were selected. The adopted point of view was the one of the hospital and the temporal horizon was of one year after the surgical operation. Direct costs per- and post-surgery were taken into account including specific surgical care and secondary surgical revision. The medical data per- and postoperative were also compared. Primary outcome measure was incremental cost per procedure.
  
  
  RESULTS
  Forty-one patients in the AVH group and 53 in the PVP group. The mean length of stay (LOS) is significantly shorter in the PVP group (3.0±1.0 days vs 10.4±4.0; P<0.001). Re-operation rate was significantly lower in the PVP group (1.9% vs 19.5% P<0.001). The cost analysis shows a mean additional cost of 1450 euros for the AVH group.
  
  
  CONCLUSIONS
  PVP was cost-effective because it was more economic and it lead to lower re-operation rate until one year of follow-up than in the AVH group. Nevertheless, these data deserve to be nuanced by unfavorable results of the AVH in comparison with those of the literature.
authors.affiliation: Service de pharmacie, CHRU de Tours, 37044 Tours cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Raimbault
authors.affiliation: Service de pharmacie, CHRU de Tours, 37044 Tours cedex 9, France.
authors.forename: S
authors.initials: S
authors.lastname: Watt
authors.affiliation: Service de pharmacie, CHRU de Tours, 37044 Tours cedex 9, France.
authors.forename: H
authors.initials: H
authors.lastname: Bourgoin
authors.affiliation: Service d'urologie, CHRU de Tours, hôpital Bretonneau, 2, boulevard Tonnellé, 37044 Tours cedex 9, France; Université François-Rabelais de Tours, PRES Centre-Val-de-Loire université, 37000 Tours, France.
authors.forename: N
authors.initials: N
authors.lastname: Brichart
authors.affiliation: Service d'urologie, CHRU de Tours, hôpital Bretonneau, 2, boulevard Tonnellé, 37044 Tours cedex 9, France; Université François-Rabelais de Tours, PRES Centre-Val-de-Loire université, 37000 Tours, France. Electronic address: f.bruyere@chu-tours.fr.
authors.forename: F
authors.initials: F
authors.lastname: Bruyère
mesh_terms: D000368:Aged; D005602:France; D017721:Hospital Costs; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D011183:Postoperative Complications; D011446:Prospective Studies; D011468:Prostatectomy; D011470:Prostatic Hyperplasia / Q000191:economics / Q000601:surgery*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies
keywords: Adenomectomy; Adénomectomie; Analyse coût–efficacité; Benign prostate hyperplasia; Cost analysis; Greenlight; Hypertrophie de la prostate; Laser