[Cost analysis of GreenLight photoselective vaporization of the prostate versus standard transurethral resection of the prostate: Benefit of ambulatory care]

Abstract

Purpose: To compare the costs associated with GreenLight XPS 180W photoselective vaporization of the prostate (PVP) for an outpatient versus standard transurethral resection of the prostate (TURP) with a three nights hospitalization in a French private hospital.

Material and methods: A retrospective cost minimization analysis was performed between 2017 and 2019 in a French private hospital for the hospital stays associated with TURP and PVP procedures for benign prostatic hyperplasia (BPH). The peri-operative cost-benefit assessment of the two procedures was analyzed from the establishment's point of view according to the micro-costing method.

Results: 871 surgical treatment for BPH had been performed during the period of the study, including 743 photoselective laser vaporization (85%). The average length of stay of patients undergoing TURP was 3,7 days versus 0,9 days for PVP including 64,7% ambulatory. The cost-benefit was more of 500€ per patient in favor of ambulatory PVP compared with TURP in conventional three nights hospitalization for level 1 hospital stays.

Conclusion: In this private hospital center, ambulatory PVP seemed more cost-effective than TURP with a three nights hospitalization for a severity level 1 patient. The financial profit for the establishment was mostly due to reduction of the main length of stay and ambulatory care.

Level of evidence: 3.

Keywords: Ambulatoire; Ambulatory surgery; Analyse de coût; Benign prostate hyperplasia; Costs and cost analysis; Greenlight; Hypertrophie bénigne de la prostate; Laser; Laser prostatectomy; Photoselective vaporization of the prostate.