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. 2021 Nov;47(6):501-508.
doi: 10.5152/tud.2021.21262.

Trends in benign prostatic hyperplasia surgery over the years: A multicenter 14-year retrospective study

Muhammed Arif İbis  1 , Selahittin Cayan  2 , Zafer Tokatli  3 , İrfan Orhan  4 , Ramazan Ascı  5 , Fatih Kocamanoglu  6 , Erdem Akbay  2 , Onder Yaman  7
Affiliations

Trends in benign prostatic hyperplasia surgery over the years: A multicenter 14-year retrospective study

Muhammed Arif İbis et al. Turk J Urol. 2021 Nov.

Abstract

Objective: The aim of this study is to show the surgical trend over the past 14 years using the data from five major centers in Turkey with accumulated experience in benign prostatic hyperplasia (BPH) surgery.

Material and methods: This study included 94,954 patients with low urinary tract symptoms (LUTSs) secondary to BPH. By using electronic databases, we identified 7,163 patients who underwent BPH surgery, including monopolar transurethral prostate resection (M-TURP), bipolar transurethral prostate resection (BTURP), transurethral incision of the prostate (TUIP), open prostatectomy (OP), and holmium laser enucleation of the prostate (HoLEP) from 2006 to 2019. The years were grouped as 2006-2010, 2011-2015, and 2016-2019.

Results: The total number of outpatient treatments for BPH increased by 72.9% from 5,379 in 2006 to 9,302 in 2019. Until 2019, the annual number of surgeries increased from 375 to 937 (increasing 150%). All surgical approaches for BPH, except TUIP, were most frequently performed between the ages of 60 and 69. The rate of surgery including M-TURP, B-TURP, and TUIP was statistically different between 2006 and 2010, 2011 and 2015, and 2016 and 2019 (P < .001), except OP (P ¼ .071). The highest increase was observed in HoLEP in the first half of the 2010s compared to the second half of the 2010s. The rate of M-TURP decreased from 77.9% to 17.9% from 2016 to 2019.

Conclusion: With the aging population, the number of patients diagnosed and treated with BPH is increasing. B-TURP as a resection technique and HoLEP as an enucleation technique replace M-TURP. Healthcare services and government spending should be organized according to these data.

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Conflict of interest statement

Conflict of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
(A) A total number of outpatient visits and operations for benign prostatic hyperplasia during the 14 years in five centers. (B) Surgical rates of patients with outpatient visits for benign prostatic hyperplasia over 14 years at five centers.
Figure 2
Figure 2
(A) A total number of benign prostatic hyperplasia surgical procedures from 2006 to 2019. (B) Annual rates of benign prostatic hyperplasia surgical procedures from 2006 to 2019. M-TURP: monopolar transurethral prostate resection; B-TURP: bipolar transurethral prostate resection; TUIP: transurethral incision of the prostate; OP: open prostatectomy; HoLEP: holmium laser enucleation of the prostate.
Figure 3
Figure 3
Number of surgeries performed in 2006-2010, 2011-2015, and 2016-2019. M-TURP: monopolar transurethral prostate resection; B-TURP: bipolar transurethral prostate resection; TUIP: transurethral incision of the prostate; OP: open prostatectomy; HoLEP: holmium laser enucleation of the prostate.
Figure 4
Figure 4
(A) A total number of transurethral surgical procedures except for TUIP from 2006 to 2019. (B) Annual rates of transurethral surgical procedures except for TUIP from 2006 to 2019. M-TURP: monopolar transurethral prostate resection; B-TURP: bipolar transurethral prostate resection; HoLEP: holmium laser enucleation of the prostate.
Figure 5
Figure 5
(A) The total number of surgeries by age group from 2006 to 2019. (B) The total number of surgeries by age group from 2006 to 2010. (C) The total number of surgeries by age group from 2011 to 2015. (D) The total number of surgeries by age group from 2016 to 2019. M-TURP: monopolar transurethral prostate resection; B-TURP: bipolar transurethral prostate resection; TUIP: transurethral incision of the prostate; OP: open prostatectomy; HoLEP: holmium laser enucleation of the prostate.
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