#0836

The Impact of MISTs on Australia BPO Surgical Trends.

D. Armany¹, L. Vo¹, S. Baskaranathan¹, H. Woo¹

¹Blacktown-Mount Druitt Hospital, Urology, Sydney, Australia

Introduction:

To evaluate the impact of Minimally Invasive Surgical Therapies (MISTs) on surgical trends for Lower Urinary Tract Symptoms (LUTS) caused by Benign Prostatic Obstruction (BPO) in Australia.

Material and methods:

Population-adjusted rates of BPO related surgeries in Australia (January 2004 – September 2024) were analysed using publically available Medicare Statistics and Census Data focusing on MBS item numbers: 36811, 37200, 37201, 37203, 37204, 37205, 37207, 37230, and 37245. Independent t-tests and significance levels compared rates before and after the introduction of Prostatic Urethral Lift (PUL) and Rezum on 1st March 2024.

Results:

From January 2004 to September 2024, 301,648 BPO-related procedures were claimed under the MBS in Australia, with Transurethral Resection of the Prostate (TURP) compromising 78% (n=235,422). PVP accounted for 11%, enucleation 4%, PUL 4%, TUNA 1%, simple prostatectomy 1%, and TUMT < 1%. Annual BPO surgery incidence rose from 112.5 to 130.2 per 100,000 adult men (2004-2023). TURP incidence peaked in 2009 but declined with increased uptake of enucleation and PVP. Post-introduction of UroLift and Rezum, most procedural rates increased, except TUNA and PUL, which declined significantly (p=0.0008; p < 0.001, respectively). TURP and PVP rates remained stable (p=0.06; p=0.14, respectively), while enucleation (p=0.008) and simple prostatectomy (p=0.027) increased. Procedures were most common in men aged 65-74, with rising rates in those aged > 85 years. CONCLUSION