Evolution of Radical Prostatectomy in the Autonomous Community of Madrid

OBJECTIVES: To analyze the implantation of laparoscopic radical prostatectomy (LRP) in the Public Health System in the Autonomous Community of Madrid (CAM) and to investigate the different results between laparoscopic and open radical prostatectomy. METHODS: We performed a retrospective analysis over a database containing data from 25 hospitals in CAM. We chose 8225 patients treated by radical prostatectomy (open or laparoscopic). Data were collected using a questionnaire including hospital, length of stay, readmissions and mortality. Values are shown in number, percentage and rank. Statistical significance is shown with p<0.05. RESULTS: Increase of LRP is shown in the period of study, representing only a 11.9% of the radical prostatectomies in 2004 and reaching 56.8% in 2012. There were no significant statistical differences in age, severity or readmissions when stratified by hospital or by technique. We found a 1.05 days increase in length of stay in long-standing hospitals compared to newer hospitals. We also found a decrease in length of stay in LRP group compared to open retropubic prostatectomy (ORP): 4.84 days vs 6.79 days, (p<0.001). CONCLUSIONS: RP is consolidated as a therapy in CAM. LRP has been successfully implemented in CAM, offering advantage over ORP in terms of hospital stay. We observed statistically significant difference in length of stay in advantage of recent hospitals regarding long-standing.