Holmium laser resection of the prostate is more cost effective than transurethral resection of the prostate: Results of a randomized prospective study

Objectives. A cost-effectiveness analysis was carried out comparing electrosurgical transurethral resection of the prostate (TURP) with holmium:yttrium-aluminum-garnet laser resection of the prostate (HoLRP). Methods. One hundred twenty patients with benign prostatic hyperplasia and urodynamically proved obstruction were randomized to undergo either TURF or HoLRP. Economic and clinical outcome data were recorded prospectively out to I year postoperatively. Results. The HoLRP group experienced fewer complications and had a shorter hospital stay and catheterization time than the TURF group, with equivalent clinical outcomes at 12 months. HoLRP cost 24.5% less (New Zealand dollars $651) than TURF during the first year. Conclusions. Because the clinical outcomes out to 1 year were equivalent, HoLRP was more cost-effective than TURF. On the basis of these savings, a minimum of 93 cases per year are required to recover the capital and service costs of the holmium:yttrium-aluminum-garnet laser. UROLOGY 57: 454-458, 2001. (C) 2001, Elsevier Science Inc.