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Montesino San Martín, Manuel

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Montesino San Martín

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Manuel

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Estadística, Informática y Matemáticas

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0000-0002-0822-600X

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Author: Galbete Jiménez, Arkaitz × Item Type: Publication ×

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    PublicationOpen Access
    Prostatic artery embolization versus transurethral resection of the prostate: a post hoc cost analysis of a randomized controlled clinical trial
    (Springer Nature, 2021) Capdevila, Ferran; Insausti, Íñigo; Galbete Jiménez, Arkaitz; Sánchez Iriso, Eduardo; Montesino San Martín, Manuel; Estadística, Informática y Matemáticas; Estatistika, Informatika eta Matematika; Economía; Ekonomia
    Purpose: to perform a post hoc analysis of patient-incurred costs in a randomized controlled clinical trial comparing prostatic artery embolization (PAE) and transurethral resection of the prostate (TURP). Materials and Methods: patients older than 60 years with indication of TURP were randomized to PAE or TURP procedure. After intervention and hospital discharge, patients were follow-up during 12 months The associated patient costs were categorized according to the study period: pre-intervention, intervention, hospitalization, and follow-up. Several items for both groups were analyzed within each study period. Results: the mean total costs per patient were lower for PAE (€ 3,192.87) than for TURP (€ 3,974.57), with this difference of € 781.70 being significant (p = 0.026). For most evaluated items, the mean costs were significantly higher for TURP. No significant differences were observed in the mean costs of PAE (€ 1,468.00) and TURP (€ 1,684.25) procedures (p = 0.061). However, the histopathology analysis, recovery room stay, and intraoperative laboratory analysis increased the interventional costs for TURP (€ 1,999.70) compared with PAE (€ 1,468.00) (p < 0.001). No cost differences were observed between PAE (€ 725.26) and TURP (€ 556.22) during the 12 months of follow-up (p = 0.605). None of patients required a repeat intervention during the study period. Conclusions: considering the short-term follow-up, PAE was associated with significantly lower costs compared with TURP. Future investigations in the context of routine clinical practice should be aimed at comparing the long-term effectiveness of both procedures and determining their cost-effectiveness.
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    PublicationOpen Access
    Prostatic artery embolization (PAE) using polyethylene glycol microspheres: safety and efficacy in 81 patients
    (Springer, 2022) Insausti, Íñigo; Galbete Jiménez, Arkaitz; Lucas-Cava, Vanesa; Sáez de Ocáriz, Ana; Solchaga, Saioa; Monreal, Raquel; Martínez de la Cuesta, Antonio; Alfaro, Raquel; Sun, Fei; Montesino San Martín, Manuel; Urtasun, Fermin; Bilbao Jaureguízar, José Ignacio; Estadística, Informática y Matemáticas; Estatistika, Informatika eta Matematika
    Purpose: To evaluate the safety and efficacy of prostatic artery embolization (PAE) using polyethylene glycol microspheres (PEGM) in patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH). Materials and methods: This multicentric prospective study enrolled 81 patients who underwent PAE with 400 ± 75 µm PEGM (HydroPearl®, Terumo, Japan). Results from baseline and 1-, 3-, 6-, and 12-month follow-ups were assessed for subjective outcomes including International Prostate Symptoms Score (IPSS), Quality of life (QoL), and International Index of Erectile Function, and objective outcomes such as peak urinary flow (Qmax) and post-void residual volume (PVR). The visual analogue scale, satisfaction questionnaire, prostatic volume, and prostatic specific antigen levels were also evaluated. Complications were documented using the modified Clavien-Dindo classification. Results: Technical success was obtained in all patients. Clinical success was achieved in 78.5% of patients. Before PAE, 54.3% of patients had an indwelling catheter which was removed in 75% of them after procedure. A statistically significant decrease was observed in IPSS and QoL from baseline to 12 months (20.14 vs 5.89; 4.8 vs 0.63, P <.01), respectively. Objective outcomes also showed a statistically significant improvement in Qmax (+ 114.9%; P <.01), achieving a maximum urinary flow of 14.2 mL/sec, and PVR (decrease 58%; P <.05) at 12 months. Minor complications (Clavien-Dindo grades I-II) occurred in 13.6% of patients, without major complications observed. Conclusion: PAE with PEGM is safe and effective treatment in patients with symptomatic BPH, with a significant improvement in both subjective and objective outcomes