Category: Epidemiology, Health Policy, Socioeconomics & Outcomes
Introduction & Objective : To use real-word evidence to assess complication and quality of life outcomes after monopolar or bipolar transurethral resection of the prostate (TURP) for treatment of benign prostatic hyperplasia (BPH).
Methods : The Health Improvement Network (THIN) database holds nationally representative data on patients, conditions, consultations, treatments, and staff gathered directly from electronic medical records in around 400 UK practices, and covers around 3.5 million actively treated patients (~5% of the UK population). Data are obtained directly from primary care electronic medical systems and are organised by Read Codes. We obtained data for all men in the database who were recorded as having had TURP from January 2010 to December 2014 and their primary care data for 12 months before and after the procedure.
Results : In 2010–14, 1,678 men were recorded as having undergone TURP (Read Code 7B390). Before TURP, 837 (50%) of these patients had the urinary symptoms urinary retention, urinary tract infections, haematuria, or cystitis. There were 564 (34%) patients receiving medication to manage BPH. After TURP, the number of patients with urinary symptoms fell, but they were still recorded in 494 (29%) patients, and more men suffered urinary infections than before TURP (221 [13%] before TURP versus 356 [21%] after TURP). The number of men taking BPH medication remained high at 376 (23%). Repeat TURP was recorded for 242 (14%) patients. Sixty-seven (4%) patients were referred from primary care to urologists after TURP, and psychosexual dysfunction was more prevalent after surgery than before (105 [6%] versus 73 [4%]).
Conclusions : Around half of men having TURP achieve symptom relief, but in a substantial number symptoms and medication use persist. Less-invasive and earlier interventions might further reduce long-term problems after surgical treatment for BPH.
Oliver Kayes– Urologist, LTHT, Leeds, England, United Kingdom