PVP more cost-effective than TURP in BPH, VA data indicate

Even considering the weight of many unknown variables such as the costs of operating room nursing and equipment replacement, it appears that costs for photoselective vaprization of the prostate (PVP) for BPH are substantially less than those seen with transurethral resection of the prostate (TURP).

A study from the Malcolm Randall VA Medical Center in Gainesville, FL, examined Veterans Administration records of 6,718 TURP patients and 772 patients undergoing PVP (GreenLight Laser Therapy, American Medical Systems, Minnetonka, MN). Study authors reported that the costs of PVP in the VA Healthcare System were $7,401 compared to $10,965 for TURP.

"Even though we hate to talk about costs in terms of how we treat our veterans, we have to recognize that they do play a role when we are talking about taxpayer money," first author Daniel Willis, MD, told Urology Times.

He observed that although data show that PVP and TURP are equally efficacious, the PVP procedure has the advantage of having a shorter average length of hospital stay at 1.3 days compared to 2.5 days for TURP.

The study weighed a host of factors such as patient comorbidities, costs of initial therapies, hospital stay, follow-up, and costs related to post-procedure adverse events. Although there were differences among all these factors, it was length of stay that had the greatest influence on cost differentials, reported Dr. Willis, who worked on the study with Uniyme Nseyo, MD, and colleagues.

Dr. Willis acknowledged that because of government coding, the specific costs reported in the study might not be readily comparable or translatable to private or institutional practices. He said the substantial differences found by his group’s study should prompt a similar review of costs in the private sector.