A Clinical Outcomes and Cost Analysis Comparing Photoselective Vaporization of the Prostate to Alternative Minimally Invasive Therapies and Transurethral Prostate Resection for the Treatment of Benign Prostatic Hyperplasia

Purpose: We critically evaluated the clinical outcomes and cost characteristics of alternative procedural treatment options for symptomatic benign prostatic hyperplasia.Materials and Methods: An outcomes and cost analysis was performed for benign prostatic hyperplasia treatments, including photoselective vaporization, microwave thermotherapy, transurethral needle ablation, interstitial laser coagulation and transurethral resection. Clinical outcomes were measured by the percent improvement in American Urological Association/International Prostate Symptom Score, the maximum uroflowmetry rate and quality of life score. An economic simulation model was constructed to estimate the expected cost of benign prostatic hyperplasia procedural therapies from a payer perspective. The model included costs of initial treatment, followup care, adverse events and re-treatment. Sensitivity and threshold analyses tested the impact of changing model inputs on base case results.Results: Ablative therapies showed better impro...