Transurethral resection or incision of the prostate and other therapies: asurvey of treatments for benign prostatic obstruction in the UK

Objective To establish the current usage of transurethral incision of the p rostate (TUIP) and other forms of treatment for benign prostatic obstructio n (BPO), Methods The Prostate Trial Office (PROTO) sent a survey questionnaire to al l 376 consultant urologists in the UK which asked for estimates of their cl inical practice in treating BPO, The survey had three principle aims: to as sess the role that the determination of prostate size has in clinical pract ice, to determine the nature and frequency of use of a range of therapies i ncluding TUIP, and to examine the feasibility of conducting a randomized co ntrolled trial comparing transurethral resection of the prostate (TURP) and TUIP. Results Of the 376 urologists, 349 replied (response rate 93%); most respon dents used prostate size as a determinant when deciding on therapy for BPO (60%). Of their patients with BPO who were treated. 38% received surgical t reatment, 33% drug therapies and 29% conservative management, Of the types of surgical treatment, the most commonly used procedure was TURF, in 79% of patients, with only 15% undergoing TUIP, When compared with TURF, TUIP ten ded to be used for patients with a mean prostate volume of less than or equ al to 25 mt. Only 6% of surgical patients were treated using minimally inva sive techniques. Conclusion This survey provides some evidence that prostate size prays an i mportant role in determining the treatment; TUIP appeared to be under-used and other minimally invasive techniques are rarely used in the UK.