Abstract: PD23-08
Sources of Funding: None

Introduction

Holmium laser enucleation of the prostate (HoLEP) for the management of benign prostatic hyperplasia has two procedural steps: Enucleation of the adenoma and tissue morcellation. While a recent randomized trial evaluating the two currently available morcellators found no significant difference in morcellation efficiency an analysis of cost was not performed factoring in the expense of operating room (OR) time. Therefore, we aim to evaluate the true cost associated with each device in a matched cohort analysis.

Methods

An institutional review board approved prospectively maintained database of HoLEP patients was utilized for this study. We evaluated all patients from 2013, the last year our institution exclusively used the VersaCutâ„¢ morcellator a reusable blade device, and matched them 1:1 with the most recent patient cohort utilizing the Piranha morcellator, a disposable blade device. Statistical analysis utilizing student t-Test was performed evaluating differences in means regarding morcellation efficiency, cost of morcellation including the expense of OR time and disposable instrument costs.

Results

We identified 142 patients within our institutional database who underwent HoLEP in 2013 with the VersaCut device and matched them 1:1 to our most recent group of patients undergoing the same procedure with the Piranha. There were no statistically significant differences between the previous and most recent group with regards to patient age (69.8 versus 69.9 yrs, p=0.9) and total enucleated tissue weight (72.8 versus 77.7g, p=0.46), respectively. However, when compared with the Versacut group, morcellation efficiency (4.4 versus 7.0 g/min, p<0.01) and expense of OR time ($1420.80 versus $992.21, p<0.005) both favored the Pirahna morcellator system. When the costs of disposable instruments were factored into the analysis with OR time costs, total cost still favored the Pirahna morcellator ($1338.81versus $1637.50, p<0.05).

Conclusions

In a matched cohort comparing morcellation cost utilizing both the VersaCutâ„¢ and Piranha morcellation devices, we identified a significant improved efficiency and improved cost savings utilizing the Piranha morcellator even when controlling for disposable costs.

Funding

None