11e6bc41283d2c8ae34880c49491d87c 277712.pdf 55f9f73d0fc61e553e007449d882192751f1b9e0 277712.pdf e766703d75efcd2ea2cac4833a69490f99e53b4324b68c0de63fe7b99fe09053 277712.pdf Title: Recent Trends in the Diagnostic and Surgical Management of Benign Prostatic Hyperplasia in the U.S. from 2004 to 2017: Annual Changes in the Selection of Treatment Options and Medical Costs Subject: Background: Transurethral resection of the prostate (TURP) is the gold-standard treatment for benign prostatic hyperplasia (BPH). However, laser surgery techniques (e.g., photoselective vaporization of the prostate (PVP), holmium laser, thulium laser enucleation of the prostate (HoLEP or ThuLEP)), and minimally invasive treatment options (e.g., UroLift) are increasingly replacing TURP. This study seeks to report the annual incidence, management trends, and costs of BPH procedures in the U.S. Methods: Data analyses of U.S. health insurance claims from 2004 to 2017, collected from the de-identified Optum Clinformatics Claims Database, were performed to determine the number of BPH patients and the treatment selected. Results: A total of 51,448 patients underwent BPH procedures from 2004 to 2017. There was a significant increase in the annual rate from 770 in 2004 to 6571 in 2017. The mean patient age (SD) increased from 67.6 years old (8.4) in 2004 to 73.4 years old (8.4) in 2017. More than 60% of patients underwent cystourethroscopy and a post-void residual urine check for workup prior to surgical management. TURP was the most-common, and PVP was the second-most-common BPH procedure. Medical and total treatment costs increased, while the detection rate of prostate cancer after BPH surgery gradually decreased from 19.87% in 2004 to 5.78% in 2017. Conclusions: Our study demonstrates a recent trend in BPH management that replaces the traditional TURP technique with alternative methods. Due to rising costs, future studies should assess whether these newer methods are cost effective over the long term. Keywords: benign prostatic hyperplasia; surgery; trends Author: Francesco Del Giudice, Jin Kyu Oh, Satvir Basran, Edouard Nicaise, Phil Hyun Song, Wansuk Kim, Sang Youn Kim, Gyeong Eun Min, Koo Han Yoo, Hyuk Jin Cho, Sinyeong Lee, Alessandro Sciarra, Stefano Salciccia, Ettore De Berardinis, Vincenzo Asero, Carlo Maria Scornajenghi, Benjamin Pradere, Wojciech Krajewski, Andrea Gallioli, Matteo Ferro, Felice Crocetto, Savio Domenico Pandolfo, Riccardo Autorino, Federico Belladelli, Andrea Mari, Gian Maria Busetto, Shufeng Li, Simone Crivellaro and Benjamin Inbeh Chung Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Tue Aug 30 14:53:17 2022 CEST ModDate: Tue Aug 30 15:38:22 2022 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1446378 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- GMZEJB+VnURWPalladioL Type 1 Custom yes yes no 10 0 XGTFUQ+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 GLRSRL+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 ZOLGEJ+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 LGTZLE+CMSY10 Type 1 Builtin yes yes no 28 0 CRVMKC+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 46 0 ECNBHC+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 80 0 ECNBHE+PalatinoLinotype TrueType WinAnsi yes yes no 83 0 ECNBHG+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 86 0 ECNGFK+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 89 0 ECNBHC+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 102 0 ECNBHE+PalatinoLinotype TrueType WinAnsi yes yes no 105 0 ECNBHG+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 108 0 ECNBHC+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 122 0 ECNBHE+PalatinoLinotype TrueType WinAnsi yes yes no 125 0 ECNBHG+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 128 0 CKBPVA+EURM10 Type 1 Builtin yes yes no 138 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-07-21 02:36:44 CEST RepresentationInformation: 277712.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-07-20 14:59:29 CEST Size: 1446378 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 242 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Item: Title: Materials and Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Info: Title: Recent Trends in the Diagnostic and Surgical Management of Benign Prostatic Hyperplasia in the U.S. from 2004 to 2017: Annual Changes in the Selection of Treatment Options and Medical Costs Author: Francesco Del Giudice, Jin Kyu Oh, Satvir Basran, Edouard Nicaise, Phil Hyun Song, Wansuk Kim, Sang Youn Kim, Gyeong Eun Min, Koo Han Yoo, Hyuk Jin Cho, Sinyeong Lee, Alessandro Sciarra, Stefano Salciccia, Ettore De Berardinis, Vincenzo Asero, Carlo Maria Scornajenghi, Benjamin Pradere, Wojciech Krajewski, Andrea Gallioli, Matteo Ferro, Felice Crocetto, Savio Domenico Pandolfo, Riccardo Autorino, Federico Belladelli, Andrea Mari, Gian Maria Busetto, Shufeng Li, Simone Crivellaro and Benjamin Inbeh Chung Subject: Background: Transurethral resection of the prostate (TURP) is the gold-standard treatment for benign prostatic hyperplasia (BPH). However, laser surgery techniques (e.g., photoselective vaporization of the prostate (PVP), holmium laser, thulium laser enucleation of the prostate (HoLEP or ThuLEP)), and minimally invasive treatment options (e.g., UroLift) are increasingly replacing TURP. This study seeks to report the annual incidence, management trends, and costs of BPH procedures in the U.S. Methods: Data analyses of U.S. health insurance claims from 2004 to 2017, collected from the de-identified Optum Clinformatics Claims Database, were performed to determine the number of BPH patients and the treatment selected. Results: A total of 51,448 patients underwent BPH procedures from 2004 to 2017. There was a significant increase in the annual rate from 770 in 2004 to 6571 in 2017. The mean patient age (SD) increased from 67.6 years old (8.4) in 2004 to 73.4 years old (8.4) in 2017. More than 60% of patients underwent cystourethroscopy and a post-void residual urine check for workup prior to surgical management. TURP was the most-common, and PVP was the second-most-common BPH procedure. Medical and total treatment costs increased, while the detection rate of prostate cancer after BPH surgery gradually decreased from 19.87% in 2004 to 5.78% in 2017. Conclusions: Our study demonstrates a recent trend in BPH management that replaces the traditional TURP technique with alternative methods. Due to rising costs, future studies should assess whether these newer methods are cost effective over the long term. 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