The decline of TURP—An Irish experience

Summary 

Objective

Transurethral prostatectomy (TURP) was once the commonest therapeutic urological surgery performed and the unequivocal gold standard treatment for lower urinary tract symptoms (LUTS). However, efficacious pharmacological therapy and improved understanding of the history of benign prostatic hyperplasia (BPH) have impacted upon this. The aim of our study was to assess the transformation in TURP practice in Ireland over the past decade by comparing numbers of the operation being performed over two different time periods (1996–1998 vs. 2001–2003).

Methods

Numbers of discharges of patients with procedure code TURP (ICD-9-CM 60.2) between 1996–1998 and 2001–2003 were obtained from the National Hospital Inpatient Enquiry database. Population data were obtained from National Censuses. Calculations were expressed per 100,000 of male population ≥50 years of age.

Results

The number of TURPs performed has fallen from a national average of 587.16/annum/100,000 male population ≥50 years of age between 1996 and 1998 to 371.54/annum/100,000 male population ≥50 years of age between 2001 and 2003, a drop of ∼40%. Furthermore, each health board region has witnessed sizeable declines.

Conclusions

The Irish experience of LUTS treatment mirrors that across developed nations globally. We believe potentially serious implications exist for standards of care, clinical practice and training.

Keywords: LUTS, TURP, BPH, Decline, Health board, Ireland