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Randomized Controlled Trial
. 2021 Nov;44(11):1771-1777.
doi: 10.1007/s00270-021-02920-3. Epub 2021 Jul 20.

Prostatic Artery Embolization Versus Transurethral Resection of the Prostate: A Post Hoc Cost Analysis of a Randomized Controlled Clinical Trial

Ferran Capdevila  1   2   3 , Iñigo Insausti  4   5 , Arkaitz Galbete  4   6   7   8   9 , Eduardo Sanchez-Iriso  6   7 , Manuel Montesino  4   6   7
Affiliations
Randomized Controlled Trial

Prostatic Artery Embolization Versus Transurethral Resection of the Prostate: A Post Hoc Cost Analysis of a Randomized Controlled Clinical Trial

Ferran Capdevila et al. Cardiovasc Intervent Radiol. 2021 Nov.

Abstract

Purpose: To perform a post hoc analysis of patient-incurred costs in a randomized controlled clinical trial comparing prostatic artery embolization (PAE) and transurethral resection of the prostate (TURP).

Materials and methods: Patients older than 60 years with indication of TURP were randomized to PAE or TURP procedure. After intervention and hospital discharge, patients were follow-up during 12 months The associated patient costs were categorized according to the study period: pre-intervention, intervention, hospitalization, and follow-up. Several items for both groups were analyzed within each study period.

Results: The mean total costs per patient were lower for PAE (€ 3,192.87) than for TURP (€ 3,974.57), with this difference of € 781.70 being significant (p = 0.026). For most evaluated items, the mean costs were significantly higher for TURP. No significant differences were observed in the mean costs of PAE (€ 1,468.00) and TURP (€ 1,684.25) procedures (p = 0.061). However, the histopathology analysis, recovery room stay, and intraoperative laboratory analysis increased the interventional costs for TURP (€ 1,999.70) compared with PAE (€ 1,468.00) (p < 0.001). No cost differences were observed between PAE (€ 725.26) and TURP (€ 556.22) during the 12 months of follow-up (p = 0.605). None of patients required a repeat intervention during the study period.

Conclusions: Considering the short-term follow-up, PAE was associated with significantly lower costs compared with TURP. Future investigations in the context of routine clinical practice should be aimed at comparing the long-term effectiveness of both procedures and determining their cost-effectiveness.

Level of evidence: Level 1 (a-c).

Keywords: Benign prostatic hyperplasia; Costs; Prostatic artery embolization (PAE); Transurethral resection of the prostate (TURP).

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Patient flow chart
Fig. 2
Fig. 2
Summary of the mean patient costs for PAE and TURP. Abbreviations: PAE = prostatic artery embolization; TURP = transurethral resection of the prostate
See this image and copyright information in PMC

Comment in

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