A COST-EFFECTIVENESS ANALYSIS OF TRANSURETHRAL RESECTION OF THE PROSTATE AND TRANSURETHRAL MICROWAVE THERMOTHERAPY FOR TREATMENT OF BENIGN PROSTATIC HYPERPLASIA - 2-YEAR FOLLOW-UP

Objective: To compare costs of transurethral prostatic resection (TURP ) and transurethral microwave thermotherapy (TUMT) for symptomatic ben ign prostatic hyperplasia (BPH) in a randomized, controlled trial. Met hods: In 70 BPH patients all costs were calculated for management, inc luding complications and repeat treatment, during TURF or TUMT and 24- month followup. Clinical outcome was judged from Madsen-Iversen sympto m score, peak urinary flow and residual urine. The effect of changes i n some critical variables was assessed by sensitivity analysis. A cost -effectiveness analysis was carded out to compare the two methods. Res ults: Symptom reduction after 2 years was 92% in the TURF group and 83 % in the TUMT group. The total costs over 2 years were SEK 24,234 and 14,830 in the respective groups. Costs for retreatments were higher af ter TUMT, while complication costs were higher in the TURF group. TUMT costs depend on the investment for the equipment, including disposabl e probes, and the degree of its utilization. TUMT was more cost-effect ive than TURF in relieving BPH-related symptoms during the 2-year foll ow-up. Conclusions: Primary treatment costs were lower for TUMT than f or TURF. Complication costs were higher in the trial's TURF arm, while retreatment costs were greater in the TUMT arm. TUMT costs depend on investment in and utilization of the equipment and reuse of treatment probes. TUMT was more cost-effective than TURF in the 2-year study per iod.