COSTS OF MINIMALLY INVASIVE LASER-SURGERY COMPARED WITH TRANSURETHRALELECTROCAUTERY RESECTION OF THE PROSTATE

We reviewed hospital charges for patients undergoing uncomplicated end oscopic surgical resection for symptomatic bladder outlet obstruction due to benign prostatic hyperplasia over a 1-year period at a single i nstitution. Of 115 patients, 67 underwent transurethral electrocautery resection of the prostate, and 48 underwent endoscopic neodymium:yttr ium-aluminum-garnet laser ablation of the prostate under direct vision . Analysis showed a cost differential between these 2 surgical treatme nts in excess of $2,000, favoring laser prostatectomy (P < .0001) over transurethral electrocautery resection. The single greatest differenc e between the treatments was the ability to manage all patients receiv ing laser treatment as outpatients, whereas the mean and median hospit al stay after transurethral electrocautery resection was 3.0 days. Tak ing additional cost variables into account and decreasing the cost of laser delivery systems would further increase this cost differential i n favor of laser therapy. The diminished postoperative morbidity assoc iated with laser treatment also promises lower total costs over the lo ng term.