Presented by: Karin Lifshitz MD
Tel Aviv Medical center, Department of Urology

Introduction

Surgical management options for BPH have changed considerably over the past 20 years. Therefore, we aimed to investigate national BPH surgical trends in the Israeli population.

Materials

 

The study cohort comprised 13,521 consecutive BPH surgeries performed between 2010-2022 in 7 academic centers. Analysis was performed by number and types of surgery, demographic data, hospital stay, and the influence of introducing holmium laser enucleation of the prostate (HoLEP).  

Results

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There were 9916 (73%) transurethral resections of the prostate (TURP), 1644 (12%) open surgeries, 1542 (12%) HoLEP, and 419 (3%) other surgeries. An annual increment of 5% for an overall cumulative increase of 68% over 12 years was noted (Figure). The introduction of HoLEP determined the disappearance of open surgeries and a decreasing tendency to perform TURPs. The overall patients’ average age was 72.4 (9.5 ± SD) years, slightly increasing to 73.1 (8.6 ± SD) in the last year of the study. The overall hospital stay was 3.4 days (4.3 ± SD) for the entire cohort, with a statistically significant decrease over time (1.3 ± SD; p < 0.05). HoLEP had an average stay of 1.6 (1.4 ± SD), statistically significantly shorter in comparison to open and other endoscopic surgeries (p < 0.05). Overall, there was a temporal statistically significant decrease in hospital stay (3.9 vs. 2.6 days; p < 0.05).  

Conclusion

The number of BPH surgical treatments in Israel is constantly increasing with a shift to minimally invasive procedures and, subsequently, the abandonment of open surgery. Despite a constant increase in the age of the population, the average age for surgery did not significantly increase. The 68% cumulative increment in BPH surgeries over the years suggests that more comprehensive and faster implementation of size-independent, short-hospitalization approaches (e.g., HoLEP) can benefit both patients and the medical system.

 

Funding

This study was not funded by any external sources

Co-Authors

Hen Hendel, MD
Division of Urology ,Rabin Medical Center

Yaron Ehrlich, MD
Division of Urology ,Rabin Medical Center

Omer Anis, MD,PhD
Sheba medical center, Urology

Zohar Dotan, MD
Sheba medical center, Urology

Guy Verhovsky, MD
Shamir Medical Center, Urology

Ehud Gnessin, MD
Shamir Medical Center, Urology

Rabeea Moed, MD
Soroka Medical Center, Urology

Nicola Mabjeesh, MD
Soroka Medical Center, Urology

Mahmood Abbas, MD
Shaare Zedek Medical Center, Urology

Ilan Kafka, MD
Shaare Zedek Medical Center, Urology

Ali Safadi, MD
Ziv medical center

Ran Katz, MD
Ziv medical center

Ofer Yossepowitch, MD
Tel Aviv Medical center

Mario Sofer, MD
Tel Aviv medical center