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- Title
Benign prostatic hyperplasia surgical treatment trends in the Public Health System in São Paulo, Brazil.
- Authors
Gomes Barbosa, Álan Roger; Seiti Takemura, Lucas; Santos Amaral, Breno; Langer Wroclawski, Marcelo; Alfer Jr., Wladimir; Otero Gil, Antonio; Monteiro Jr., José; Budib Lourenço, Danilo; Doyun Cha, Jonathan; Apezzato, Marcelo; Brunhara Alves Barbosa, João Arthur; Bianco, Bianca; Caserta Lemos, Gustavo; Carneiro, Arie
- Abstract
Objective: To describe and compare the number of surgeries, mortality rate, length of hospital stay, and costs of transurethral resection of the prostate and open prostatectomy for the treatment of benign prostatic hyperplasia, between 2008 and 2018, in the Public Health System in São Paulo, Brazil. Methods: Ecological and retrospective study using data from the informatics department of the Brazilian Public Health System database. Procedure codes were "open prostatectomy" and "transurethral resection of the prostate." The outcomes analyzed were compared between transurethral resection of the prostate and open prostatectomy according to the hospital surgical volume and presence or absence of a residency program. Results: A total of 18,874 surgeries were analyzed (77% transurethral resection of the prostate) and overall mortality was not statistically different between procedures. Intermediate and high-volume centers had shorter length of hospital stay than low-volume centers for transurethral resection of the prostate (3.28, 3.02, and 6.58 days, respectively, p=0.01 and p=0.004). Length of hospital stay was also shorter for open prostatectomy in high-volume compared to low-volume centers (4.86 versus 10.76 days, p=0.036). Intrahospital mortality was inversely associated with surgical volume for transurethral resection of the prostate. Centers with residency program had shorter length of hospital stay considering open prostatectomy and less mortality regarding transurethral resection of the prostate. Open prostatectomy was 64% more expensive than transurethral resection of the prostate. Conclusion: The findings suggest the importance of investing in specialized centers, which could be potential referral centers for surgical cases.
- Subjects
BENIGN prostatic hyperplasia; LENGTH of stay in hospitals; PUBLIC health; PROSTATECTOMY; SURGERY; SURGICAL complications; SURGICAL excision; MORTALITY; TRANSURETHRAL prostatectomy
- Publication
Einstein (16794508), 2022, Vol 20, p1
- ISSN
1679-4508
- Publication type
Article
- DOI
10.31744/einstein_journal/2022AO6880