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Mortality after transurethral and open prostatectomy in Scotland
T B Hargreave1, C F Heynes, S W Kendrick
1Information and Statistics Division, National Health Service, Scotland.
British Journal of Urology
|April 1, 1996
Summary
Transurethral prostatectomy (TURP) shows a slightly increased risk of late mortality compared to open prostatectomy. This finding persists even after accounting for patient health, suggesting potential differences in patient selection or surgical effects.
Area of Science:
- Urology
- Public Health
- Epidemiology
Background:
- Transurethral prostatectomy (TURP) and open prostatectomy are common procedures for benign prostatic hyperplasia.
- Previous studies suggested a potential increase in mortality following TURP compared to open prostatectomy.
Purpose of the Study:
- To investigate the comparative late mortality risk between TURP and open prostatectomy using linked Scottish medical and death records.
- To analyze mortality risks based on specific causes of death and patient comorbidities.
Main Methods:
- Utilized a large dataset of linked hospital, cancer, and death records in Scotland (1968-1989).
- Analyzed cohorts of men aged 55-84 who underwent prostatectomy, calculating relative risks of late mortality.
- Adjusted for age, cancer diagnosis, and prior/concurrent circulatory and respiratory conditions.
Main Results:
- TURP was associated with a 13-15% increased relative risk of late mortality compared to open prostatectomy, even after adjustments.
- No increased risk of circulatory disease mortality was observed with TURP.
- Increased mortality risk from respiratory conditions and cancer (prostate, bladder) was noted after TURP.
Conclusions:
- The study confirms an increased risk of late mortality after TURP compared to open prostatectomy.
- Limitations in coding comorbidities and patient condition details mean pre-operative patient selection may influence observed mortality differences.