Introduction: The aim of the study is to compare length of hospital stay, transfusion rates, and re-intervention rates during hospitalization for transurethral resection of the prostate (TUR-P), open prostatectomy (OP), and laser therapy (LT) for surgical treatment of benign prostatic obstruction (BPO). Methods: URO-Cert is an organization, in which clinical data of prostatic diseases from 2 university, 19 public, and 3 private hospitals and 270 office-based urologists are collected in order to document treatment quality. Data on diagnostics, therapy, and course of disease are recorded web based. The analysis includes datasets from 2005 to 2017. Results: Of 10,420 patients, 8,389 were treated with TUR-P, 1,334 with OP, and 697 with LT. Median length of hospital stay was 6 days (IQR: 4–7) for TUR-P, 9 days (IQR: 7–11) for OP, and 5 days (IQR: 4–6) for LT (p < 0.001). Risk for a hospital stay ≥7 days was higher for OP versus TUR-P (OR: 7.25; 95% CI = 6.27–8.36; p < 0.001) and LT (OR: 17.89; 95% CI = 14.12–22.65; p < 0.001) and higher for TUR-P versus LT (OR: 2.47; 95% CI = 2.03–3.01; p < 0.001). OP had a significantly higher risk for transfusions than TUR-P (OR: 2.44; 95% CI = 1.74–3.41; p < 0.001) and LT (OR: 3.32; 95% CI = 1.56–7.01; p < 0.001). Transfusion rates were not significantly different between TUR-P and LT (OR: 1.36; 95% CI = 0.66–2.79; p = 0.51). Risk of re-intervention was not different between all 3 approaches. Conclusion: OP was associated with higher transfusion rates and longer hospital stay than TUR-P and LT. Risk of transfusion was not different between TUR-P and LT, but TUR-P was inferior to LT concerning length of hospital stay. Re-intervention rates during hospitalization did not differ between the groups.

1.
Berges
RR
,
Pientka
L
,
Höfner
K
,
Senge
T
,
Jonas
U
.
Male lower urinary tract symptoms and related health care seeking in Germany
.
Eur Urol
.
2001 Jun
;
39
(
6
):
682
7
.
2.
Kahokehr
A
,
Gilling
PJ
.
Enucleation techniques for benign prostate obstruction: which one and why
.
Curr Opin Urol
.
2014 Jan
;
24
(
1
):
49
55
.
3.
European Association of Urology
.
EAU guidelines presented at the EAU annual congress Barcelona 2019
.
Arnhem, The Netherlands
:
EAU Guidelines Office
;
2019
.
4.
Bschleipfer
T
,
Bach
T
,
Berges
R
,
Dreikorn
K
,
Gratzke
C
,
Madersbacher
S
,
.
(S2e guideline of the German urologists. Instrumental treatment of benign prostatic hyperplasia)
.
Urologe
.
2016 Feb
;
55
(
2
):
195
207
.
5.
Mavuduru
RM
,
Mandal
AK
,
Singh
SK
,
Acharya
N
,
Agarwal
M
,
Garg
S
,
.
Comparison of HoLEP and TURP in terms of efficacy in the early postoperative period and perioperative morbidity
.
Urol Int
.
2009
;
82
(
2
):
130
5
.
6.
Zhong
J
,
Feng
Z
,
Peng
Y
,
Liang
H
.
A systematic review and meta-analysis of efficacy and safety following holmium laser enucleation of prostate and transurethral resection of prostate for benign prostatic hyperplasia
.
Urology
.
2019 Sep
;
131
:
14
20
.
7.
Yin
L
,
Teng
J
,
Huang
CJ
,
Zhang
X
,
Xu
D
.
Holmium laser enucleation of the prostate versus transurethral resection of the prostate: a systematic review and meta-analysis of randomized controlled trials
.
J Endourol
.
2013 May
;
27
(
5
):
604
11
.
8.
Broggi
E
,
May
A
,
Giretti
G
,
Tabchouri
N
,
Lorphelin
H
,
Brichart
N
,
.
Long-term outcomes of 80-watt KTP and 120-watt HPS green light photoselective vaporization of the prostate
.
Urol Int
.
2014
;
93
(
2
):
229
36
.
9.
Cornu
JN
,
Ahyai
S
,
Bachmann
A
,
de la Rosette
J
,
Gilling
P
,
Gratzke
C
,
.
A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction: an update
.
Eur Urol
.
2015 Jun
;
67
(
6
):
1066
96
.
10.
Strope
SA
,
Yang
L
,
Nepple
KG
,
Andriole
GL
,
Owens
PL
.
Population based comparative effectiveness of transurethral resection of the prostate and laser therapy for benign prostatic hyperplasia
.
J Urol
.
2012
;
187
:
1341
5
.
11.
Al-Ansari
A
,
Younes
N
,
Sampige
VP
,
Al-Rumaihi
K
,
Ghafouri
A
,
Gul
T
,
.
Green light HPS 120-W laser vaporization versus transurethral resection of the prostate for treatment of benign prostatic hyperplasia: a randomized clinical trial with midterm follow-up
.
Eur Urol
.
2010
;
58
(
3
):
349
55
.
12.
Gilfrich
C
,
Leicht
H
,
Fahlenbrach
C
,
Jeschke
E
,
Popken
G
,
Stolzenburg
JU
,
.
Morbidity and mortality after surgery for lower urinary tract symptoms: a study of 95,577 cases from a nationwide German health insurance database
.
Prostate Cancer Prostatic Dis
.
2016 Dec
;
19
(
4
):
406
11
.
13.
Herden
J
,
Ebert
T
,
Schlager
D
,
Pretzer
J
,
Zumbé
J
,
Sommerfeld
HJ
,
.
Treatment mapping of lower urinary tract symptoms due to benign prostatic hyperplasia-an analysis of the Governing body of German prostate centers
.
Urologe A
.
2020 Sep
;
59
(
9
):
1082
91
.
14.
Brehmer
B
,
Berges
R
,
Ebert
T
,
Goepel
M
,
Heidenreich
A
.
Documentation of the Governing body of prostate centers (DVPZ)
.
Urologe A
.
2013 Mar
;
52
(
3
):
408
13
.
15.
Neyer
M
,
Reissigl
A
,
Schwab
C
,
Pointner
J
,
Abt
D
,
Bachmayer
C
,
.
Bipolar versus monopolar transurethral resection of the prostate: results of a comparative, prospective bicenter study perioperative outcome and long-term efficacy
.
Urol Int
.
2013
;
90
(
1
):
62
7
.
17.
Reimann
M
,
Fishman
N
,
Almedom
Z
,
Lichy
I
,
Buckendahl
J
,
Steiner
U
,
.
Perioperative changes and progress in photoselective vaporization of the prostate with green light XPS 180 W System: a single center experience
.
Urol Int
.
2018
;
100
(
4
):
463
9
.
18.
Tietze
S
,
Kiehle
B
,
Krause
J
,
Behrendt
W
,
Hamza
A
.
Laser therapy for bladder outlet obstruction: a prospective analysis of all patients receiving treatment with the greenlight XPS 180-W laser system after introduction at a single center
.
Urol Int
.
2015
;
95
(
3
):
293
9
.
19.
Gazel
E
,
Kaya
E
,
Yalcin
S
,
Aybal
,
Aydogan
TB
,
Tunc
L
.
Comparison of the efficacy of holmium laser enucleation of the prostate in treating prostate volumes of ≤80 and > 80 mL
.
Urol Int
.
2019
;
102
(
3
):
306
10
.
20.
Chen
YB
,
Chen
Q
,
Wang
Z
,
Peng
YB
,
Ma
LM
,
Zheng
DC
,
.
A prospective, randomized clinical trial comparing plasmakinetic resection of the prostate with holmium laser enucleation of the prostate based on a 2-year followup
.
J Urol
.
2013 Jan
;
189
(
1
):
217
22
.
21.
Heidar
NA
,
Labban
M
,
Misrai
V
,
Mailhac
A
,
Tamim
H
,
El-Hajj
A
.
Laser enucleation of the prostate versus transurethral resection of the prostate: perioperative outcomes from the ACS NSQIP database
.
World J Urol
.
2020 Nov
;
38
(
11
):
2891
7
.
22.
Naspro
R
,
Suardi
N
,
Salonia
A
,
Scattoni
V
,
Guazzoni
G
,
Colombo
R
,
.
Holmium laser enucleation of the prostate versus open prostatectomy for prostates >70 g: 24-month follow-up
.
Eur Urol
.
2006 Sep
;
50
(
3
):
563
8
.
23.
Kuntz
RM
,
Lehrich
K
,
Ahyai
SA
.
Holmium laser enucleation of the prostate versus open prostatectomy for prostates greater than 100 g: 5-year follow-up results of a randomised clinical trial
.
Eur Urol
.
2008 Jan
;
53
(
1
):
160
6
.
24.
Nargund
VH
,
Noble
JG
,
Cranston
D
,
Fellows
GJ
.
Haematuria: a long-term problem after prostatectomy
.
Urol Int
.
2001
;
66
(
1
):
1
3
.
25.
Bachmann
A
,
Tubaro
A
,
Barber
N
,
D'Ancona
F
,
Muir
G
,
Witzsch
U
,
.
180-W XPS greenlight laser vaporisation versus transurethral resection of the prostate for the treatment of benign prostatic obstruction: 6-month safety and efficacy results of a European multicentre randomised trial; the goliath study
.
Eur Urol
.
2014
;
65
(
5
):
931
42
.
26.
Altay
B
,
Erkurt
B
,
Kiremit
MC
,
Horuz
R
,
Guzelburc
V
,
Albayrak
S
.
A comparison of 120 W laser photoselective vaporization versus transurethral resection of the prostate for bladder outlet obstruction by prostate cancer
.
Urol Int
.
2015
;
94
(
3
):
326
9
.
27.
Chen
Q
,
Zhang
L
,
Liu
YJ
,
Lu
JD
,
Wang
GM
.
Bipolar transurethral resection in saline system versus traditional monopolar resection system in treating large-volume benign prostatic hyperplasia
.
Urol Int
.
2009
;
83
(
1
):
55
9
.
28.
Madduri
VK
,
Bera
MK
,
Pal
DK
.
Monopolar versus bipolar transurethral resection of prostate for benign prostatic hyperplasia: operative outcomes and surgeon preferences, a real-world scenario
.
Urol Ann
.
2016 Jul
;
8
(
3
):
291
6
.
29.
Lerner
LB
,
Rajender
A
.
Laser prostate enucleation techniques
.
Can J Urol
.
2015 Oct
;
22
(
Suppl 1
):
53
9
.
You do not currently have access to this content.