Category: BPH/LUTS: Outcomes & Complications

MP11-10 - Perioperative outcomes of open versus minimally-invasive simple prostatectomy: An analysis of the National Surgical Quality Improvement Program database.

Fri, Sep 21
2:00 PM - 4:00 PM

Introduction & Objective :

Simple prostatectomy (SP) is the recommended treatment in patients with lower urinary tract symptoms (LUTS) secondary to large volume (>80 mL) benign prostatic hyperplasia (BPH) . The purpose of this research is to evaluate and compare the perioperative morbidity of open simple prostatectomy (OSP) and minimally invasive simple prostatectomy (MISP) using data from the National Surgical Quality Improvement Program (NSQIP) database .


Methods :

 NSQIP database was used to identify men that underwent OSP and MISP for BPH from 2011-2016. Associations of surgical approach with 30-day complications, blood transfusion, length of hospitalization, reoperation, and readmissions were evaluated.


Results :

A total of 1,143 patients underwent SP.  There were 891 patients who underwent OSP, and 252 underwent (MISP). A higher rate of bleeding occurrence transfusions was identified in open SP vs MISP (17.8% vs 3.6%, p <.001). Longer hospital stay was associated with open SP (mean = 3.90 vs 2.48 days, p <0.001). Shorter operation time was associated with open SP vs MISP ( mean = 115 vs 180 min, p <.001).  There was no difference in readmission rate (p = .67), unplanned reoperations ( p = .767), postoperative DVT, or wound infections.


Conclusions :

Overall the national utilization of MISP for BPH is low.  Bleeding complications that require transfusion are more common in OSP.  Increasing utilization of MISP in patients who choose to undergo SP, may reduce the need for intraoperative/postoperative transfusion, and reduce the length of hospital stay.

Adnan Dervishi

Resident
Department of Urology, University of Louisville School of Medicine
Louisville, Kentucky

Samarpit Rai

Resident
Department of Urology, University of Louisville School of Medicine
Louisville, Kentucky

Paul Knoll

Resident
Department of Urology, University of Louisville School of Medicine
Louisville, Kentucky

Murali K. Ankem

Chairman
Department of Urology, University of Louisville School of Medicine
Louisville, Kentucky

Murali Ankem, MD, MBA, is Professor and Chairman of the Department of Urology at the University of Louisville. (Louisville, KY) Dr. Ankem is a board-certified urologist specializing in minimally invasive urologic surgery, endourology and robotic oncology. Dr. Ankem earned his medical degree from Ranga Raya Medical College at Andhra University in Kakinada, India, and has completed urologic residency programs in both India and the United States. During his residency at Robert Wood Johnson Medical College at the University of Medicine and Dentistry of New Jersey, Dr. Ankem developed a strong interest in endourology and performed additional clinical research in the field. His research helped him attain an endourology fellowship position at the University of Wisconsin’s Madison Medical School. Dr. Ankem has served as an assistant and associate professor of urology at LSU Shreveport and Robert Wood Johnson Medical College respectively.

Dr. Ankem joined the University of Louisville in 2011. Since that time, Dr. Ankem has engaged in clinical research as investigator in the field of uro-oncology and minimally invasive urology. Dr. Ankem regularly participates as a session coordinator at the American Urology Association, Society of Laparoscopic Surgery and Endourology national meetings. He is also a reviewer for six urologic journals and publications. Dr. Ankem is a past president of the Kentucky Urologic Association and current member of the Executive Committee for the Southeastern Section of the American Urological Association.

Jamie Messer

Program Director
Department of Urology University of Louisville School of Medicine
Louisville, Kentucky

Ahmed Q. Haddad

Associate Professor
Department of Urology, University of Louisville School of Medicine
Louisville, Kentucky