Holmium laser resection of the prostate is more cost effective than transurethral resection of the prostate: results of a randomized prospective study.

摘要

OBJECTIVES: A cost-effectiveness analysis was carried out comparing electrosurgical transurethral resection of the prostate (TURP) with holmium:yttrium-aluminum-garnet laser resection of the prostate (HoLRP). METHODS: One hundred twenty patients with benign prostatic hyperplasia and urodynamically proved obstruction were randomized to undergo either TURP or HoLRP. Economic and clinical outcome data were recorded prospectively out to 1 year postoperatively. RESULTS: The HoLRP group experienced fewer complications and had a shorter hospital stay and catheterization time than the TURP group, with equivalent clinical outcomes at 12 months. HoLRP cost 24.5% less (New Zealand dollars Dollars 651) than TURP during the first year. CONCLUSIONS: Because the clinical outcomes out to 1 year were equivalent, HoLRP was more cost-effective than TURP. On the basis of these savings, a minimum of 93 cases per year are required to recover the capital and service costs of the holmium:yttrium-aluminum-garnet laser.