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Is transurethral resection of the prostate still justified?

Is transurethral resection of the prostate still justified? Introduction For decades TURP was the undisputed gold standard of therapy for patients with LUTS due to BPH; however, within the past 10 years this role has increasingly been challenged by the development of medical (5α reductase inhibitors, α1‐receptor blockers) and less invasive interventional alternatives [ 1 –8 ]. The main driving forces behind this development were the high prevalence of the disease, an absolute indication for surgery in only 5–10% of patients with symptomatic BPH, recent technical innovations and, most importantly, the apparently unchanged high morbidity of TURP [ 9 –16 ]. As a result, the number of prostatectomies decreased substantially [ 17 , 18 ], e.g. in the USA the number of TURPs for BPH was 253 000 within the US Medicare Program in 1987 and fell to 145 000 in 1994, a reduction of 43% [ 17 ]. This trend is also demonstrable in Europe, although less pronounced in countries with very extensive public healthcare systems [ 18 ]. Enthusiastic reports on the success of alternative treatment options in the lay and urological press seemed to herald the end of TURP as the gold standard, perhaps best reflected by Stamey's quote in 1993 that ‘TURP http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png BJU International Wiley

Is transurethral resection of the prostate still justified?

BJU International , Volume 83 (3) – Feb 1, 1999

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References (115)

Publisher
Wiley
Copyright
Copyright © 1999 Wiley Subscription Services, Inc., A Wiley Company
ISSN
1464-4096
eISSN
1464-410X
DOI
10.1046/j.1464-410x.1999.00908.x
Publisher site
See Article on Publisher Site

Abstract

Introduction For decades TURP was the undisputed gold standard of therapy for patients with LUTS due to BPH; however, within the past 10 years this role has increasingly been challenged by the development of medical (5α reductase inhibitors, α1‐receptor blockers) and less invasive interventional alternatives [ 1 –8 ]. The main driving forces behind this development were the high prevalence of the disease, an absolute indication for surgery in only 5–10% of patients with symptomatic BPH, recent technical innovations and, most importantly, the apparently unchanged high morbidity of TURP [ 9 –16 ]. As a result, the number of prostatectomies decreased substantially [ 17 , 18 ], e.g. in the USA the number of TURPs for BPH was 253 000 within the US Medicare Program in 1987 and fell to 145 000 in 1994, a reduction of 43% [ 17 ]. This trend is also demonstrable in Europe, although less pronounced in countries with very extensive public healthcare systems [ 18 ]. Enthusiastic reports on the success of alternative treatment options in the lay and urological press seemed to herald the end of TURP as the gold standard, perhaps best reflected by Stamey's quote in 1993 that ‘TURP

Journal

BJU InternationalWiley

Published: Feb 1, 1999

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