Hospital caseload thresholds for improved perioperative outcomes during transurethral resection or enucleation of the prostate: results from the GRAND study

To determine an annual hospital volume threshold after which perioperative morbidity improves for TURP, simple prostatectomy, HoLEP, and ThuLEP.

Data Source: Utilized data from the German Nationwide Inpatient Data (GRAND) registry from 2005 to 2022.
Patient Selection: Included patients who underwent TURP, simple prostatectomy, HoLEP, and ThuLEP.
Statistical Analysis: Performed ROC analyses to identify optimal annual hospital caseload thresholds for perioperative morbidity outcomes.

1,084,650 TURP, 90,735 simple prostatectomy, 64,325 HoLEP, and 15,241 ThuLEP surgeries were performed, with varying perioperative morbidity rates across procedures.
TURP showed 3.6% incontinence and 1.5% ICU admissions, while simple prostatectomy had 4.3% incontinence and 8% ICU admissions.

Higher annual hospital volumes are associated with improved perioperative outcomes for various prostate procedures.

Study limited to inpatient data and may not capture all relevant outpatient outcomes.
Findings may not be generalizable to non-German healthcare settings.

Identifying specific annual hospital volume thresholds can guide the centralization of surgical procedures to improve patient outcomes.