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Introduction
Surgical management of benign prostatic hyperplasia (BPH) has evolved, including techniques that can be used with the growing population of anticoagulated patients. We evaluated current trends in procedure utilization amongst American urologists.
Methods
A 90-item on-line survey was sent via email to: American Urological Association; Veterans Administration; Society for Government Service Urologists; Endourological Society. Data concerning utilization of 12 BPH surgical techniques were analyzed and compared to surgeons' demographics using categorical data analysis.
Results
600 urologists replied; 570 currently perform BPH surgery. Table 1 shows procedure utilization. Urologists' age, year of residency completion, and region of country had no influence on technique utilization, except in Northeastern (less monopolar TURP, p=0.04) and New York Sections (less PVP, p=0.01). Academic versus private settings were no different other than RP and Button which occur more often in academics (RP 7% vs 2%, button TURP 28% vs 21%). High volume surgeons are more likely to perform monopolar and bipolar TURP, whereas low volume surgeons are more likely to perform PVP, HoLAP, and HoLEP.
Conclusions
Change in technology has altered urologists' surgical approach to BPH. OP and monopolar TURP are still the most utilized procedures, however, bipolar and laser therapies are becoming more common. Lower volume surgeons appear to perform more laser techniques. Academic programs did not influence preference in technique except with robotic surgery and Button.
Table 1.