Back to 2024 Abstracts
An Analysis of Reoperations for Benign Prostatic Hyperplasia from a Near Real Time Live Dataset- TriNetX
Clemens An, BS
1, Benjamin Rubin, BS
1, Jake Jeong, BS
2, Richard Grunert, MD FACS
1
1University Of Vermont, Burlington, VT, USA, 2Washington University School of Medicine, St. Louis, MO, USA
BACKGROUND: TrinetX is a newly available dataset that allows for clinicians and researchers to access a relatively live dataset, approximately 212 million patients' data mainly extracted from de-identified data from electronic medical records. This dataset allows for a novel opportunity to assess true outcomes of therapy from the various participating institutions, mainly large academic centers, specialty physician practices and community hospitals. This abstract details true reoperative rates of several very commonly used procedures to treat lower urinary tracts symptoms (LUTS) for benign prostate hyperplasia (BPH) including Transurethral Resection of the Prostate (TURP) , Laser resection/vaporization, Enucleation (HoLEP/ThuLEP), steam therapy (WVTT) and prostate implants (PUL). METHODS: We conducted an observational study utilizing electronic health records linked with insurance claims obtained through the TriNetX Dataset Network (Cambridge, MA). Data collection for this study was conducted from the inception of the dataset in 2018 to March 2024. Our study cohort included adult males equal or older than 18 with a diagnosis of BPH who received an initial surgical operation and then subsequently received another surgical operation for BPH within 5 years of the initial operation. The re-operation rates for the following procedures were considered: TURP, Laser Therapy, HOLAP, WVTT, and PUL. All statistical differences between specified reoperation therapies were assessed with two sample Z-tests of proportions and statistical significance was designated at (p < 0.01). All statistical analyses were conducted on R studio (Boston, MA). RESULTS: PUL had the highest overall 5-year re-operation rate at 11.58% followed by WVTT, Laser Therapy, TURP, and HOLAP at 8.61%, 8.08%, 5.24%, and 3.33%, respectively. Statistical analysis was used to identify if there was a statistical difference in the reoperation rate between the various procedures (Table 1). Results demonstrate that reoperation rates across all groups, aside from one set (WVTT and Laser therapy), for the treatment of BPH were statistically different from one another (p<0.01). When compared to the published literature, the results were generally consistent with this data set. Amounts and rates of secondary reoperative procedures were provided as well (Table 2 and Fig). CONCLUSION: The results support that a near live ongoing dataset for evaluating the reoperation rates are fairly consistent with the published literature and can be used as an ongoing assessment of existing and novel therapies used to treat BPH. We believe that this new dataset will more broadly reflect the true patient data in the real world further empowering the clinician/researcher with true patient outcome data.
Table 1. Reoperative rates for common BPH procedures| Initial Procedure | Total # of patients | # Patients who underwent a reoperation | Trinet-X 5 year reoperative rate | Published Studied 5 year reoperative rates | Reoperative rate significance to other procedures |
| TURP | 49885 | 2615 | 5.24% | 5.88%-9.8% | p <0.01 to all other procedures |
| Laser Therapy | 32417 | 2618 | 8.08% | 6.1%-11.2% | No difference between Laser and WVTT alone , but otherwise p<0.01 to all other procedures |
| WVTT | 2742 | 236 | 8.61% | 4.4% -9.4% | See above |
| PUL | 6392 | 740 | 11.58% | 13%-28% | p <0.01 to all other procedures |
| HoLEP/ThuLEP | 11313 | 377 | 3.33% | <0.1% -8.4% | p <0.01 to all other procedures |
| | | | | |
Table 2 .Types of reoperative procedures| Initial Procedure | Types of reoperative procedure performed | Number of patients and Specified reoperative Procedures | Total reoperative rate /( specific rate breakdown |
| TURP | TURP/Laser | 2161/319 | 5.24% (4.33%, 0.64%) |
| Laser Therapy | TURP/Laser | 1104/1278 | 8.08%(3.41%, 3.94%) |
| WVTT | WVTT/Laser Therapy/TURP | 41/50/115 | 8.61%( 1.5%, 1.82%, 4.19%) |
| PUL | PUL/Laser Therapy /TURP | 227/157/341 | 11.58%( 3.55%, 2.46%, 4.91%) |
| HoLEP/ThuLEP | HoLEP/TURP | 221/100 | 3.33% (1.95%, 0.88%%) |
Back to 2024 Abstracts
