Introduction: Transurethral Resection of the Prostate (TURP) is the gold standard of treatment for bothersome lower urinary tract symptoms in men with benign prostatic hyperplasia (BPH). TURP surgeries are primarily done as an elective procedure. This study aims to evaluate hospital admissions for BPH that required TURP and identify factors that are associated with non-elective TURP in New York State.
Methods: We used NY SPARCS dataset for hospital inpatient discharges for 2013-2017 calendar years. CCS Diagnosis code for BPH and CCS Procedure code for TURP were used to extract the data. Hospital admissions were further classified based on type of visit codes as emergency (code=1), urgent (code=2), and elective (code 3). Multivariate logistic regression was used to identify factors of emergency and urgent admissions for TURP.
Results: During the 2013-2017 period, there were 9081 hospital admissions for TURP in the New York State. The majority of TURP cases were elective admissions (56%, n=5,084/9,081). However, 30% (n=2,715/9,081) of TURP cases were emergency admissions and 14% (n=1,240/9,081) were urgent admissions. Compared to elective admissions, emergency admissions were associated with Medicaid insurance (OR=1.517, 95% CI 1.270-1.813, p<0.01), African American race (OR=1.321, 95% CI 1.144-1.525, p<0.01), and Hispanic ethnicity (OR=1.182, 95% CI 1.017-1.374, p<0.05). Urgent admissions were associated with Blue Cross Blue Shield (OR=1.383, 95% CI 1.113-1.718, p<0.01), Private (OR=1.259, 95% CI 1.002-1.552, p<0.05), and Medicaid health insurance (OR=1.356, 95% CI 1.044-1.761, p<0.05), and Hispanic ethnicity (OR=1.358, 95% CI 1.102-1.673, p<0.01). Teaching hospitals were associated with higher number of emergency admissions (OR=1.245, 95% CI 1.023-1.514, p<0.05) and fewer number of urgent admissions (OR=0.386, 95% CI 0.311-0.479, p<0.01). There were no associations between patients age and non-elective TURP.
Conclusions: Patients who undergo emergency TURP are more likely to be African American, Hispanic, carry Medicaid insurance, and present to the teaching hospital. Investigating the factors associated with patient populations prone to urgent and emergent TURPs has demonstrated disparity in care for BPH. Further studies are needed to better understand the gaps in care for BPH.
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