Changing trends in the management of benign prostatic hyperplasia during recent 5 years

Purpose: Benign prostatic hyperplasia (BPH) is not uncommon, and its prevalence is increasing; its treatment is also undergoing certain changes, which are quite different from previously used treatments. The purpose of this study was to investigate the trend in BPH treatment over the last 5 years, at the Yonsei Medical Center, with its clinical implications. Materials and methods: A retrospective analysis was performed on patients diagnosed with BPH, and treated surgically and/or medically at our hospital, on an outpatient or inpatient basis, over the 5 year period from Jan 1998 to Nov 2002. The subjects were divided into surgically and medically treated groups. Prostate volume was measured by means of transrectal ultrasonography, and the proportion of the total number of BPH patients in each group identified. Results: The mean age of the medically and surgically treated groups were 65.9 and 68.5 years, respectively, with no significant difference between the groups (p > 0.05). The numbers of patients diagnosed and treated for BPH increased annually over the 5 years, and were 3,934, 5,318, 6,612, 8,466 and 9,457, respectively, and the numbers of transurethral prostate resection (TURP) performed were 241, 273, 288, 332 and 333, respectively. Although the absolute number of surgical treatments seem similar, the actual proportion; 6.1, 5.1, 4.3, 3.9 and 3.5%, respectively, showed significant decreases year-on-year (p < 0.05). Interestingly, while the overall mean prostate volume remained constant (p > 0.05), the mean prostate volume in the surgically treated group for the 5 consecutive years were 37.1, 39.3, 44.2, 49.1 and 53.6cc, respectively, showing a significant increase (p < 0.05). Conclusions: The number of BPH patients attending Yonsei Medical Center has rapidly increased over the last 5 years, with medical rather than surgical treatment becoming the primary treatment of BPH. However, despite the number of patients requiring surgical treatment appearing to have change little, the prostate volume of these patients has shown a tendency to increase.