Trends of Benign Prostatic Hyperplasia (BPH) Procedures in Ambulatory Surgery Settings - Beyond the Abstract
While HoLEP has been shown to have evidenced-based advantages relative to TURP, photovaporization (PVP), and other interventions, adoption of HoLEP has remained relatively low in the past decade based on Medicare and American College of Surgeons National Surgical Quality Improvement Program (NSQIP) data. The HCUP NASS is the only national all-payer database of ambulatory surgical encounters. Therefore, we believe that usage of this database may be more inclusive of patients not insured under Medicare.
Our data indicate that HoLEP continues to increase in uptake nationally and has overtaken PVP as the second most common BPH procedure in 2019. Although the overall number of BPH procedures fell by 20%, the number of HoLEPs performed increased from 4.7% in 2016 to 8.3% in 2019 and the proportion of HoLEPs to total BPH surgeries nearly doubled. On a regional basis, HoLEP appears to be most popular in the Midwestern and Southern United States.
As same-day discharge HoLEP becomes increasingly recognized as a safe and viable option, we believe that HoLEP will continue to increase in popularity and uptake nationwide. Despite these promising trends, HoLEP adoption continues to lag significantly behind TURP potentially due to the steep learning curve and lack of exposure during training. Further investigation will be necessary as same-day HoLEP becomes increasingly recognized as a safe and feasible option.
Written by: Jenny Guo, MD, Northwestern University Feinberg School of Medicine, Chicago, IL
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