Application of clinical and economic analysis methods in assessment of the effectiveness of benign prostatic hyperplasia surgical treatment

Abstract

Aim To determine the effectiveness of transurethral resection (TUR) and transvesical adenomectomy (TA) in the treatment of benign prostatic hyperplasia (BPH) by methods of clinical and economic analysis (CEA). Materials and methods We investigated the results of surgical treatment of BPH with the method of TA with a deaf seam of the bladder (n = 252) and a monopolar TUR (n=40). The duration of urethral drainage was 3.1 ± 0.8 and 2.9 ± 0.6 days, respectively. The cost of one treatment case for TA was 37,309.07 rubles, and for TUR - 50,391.46 rubles. Clinical efficacy (Eff) was determined from three indicators: uroflowmetry, I-PSS, and QoL with performance criteria set for them. In the TA group after 1 month after the operation Eff was 100%. In the TUR group after the same period, Eff by three indicators was 43.3%. Drug therapy (DT) with tolterodine and tamsulosin for 2 months allowed to achieve 100% Eff in the TUR group, but led to an increase in the cost of treatment. CEA was determined by using the cost-effectiveness and cost minimization methods. Conclusion TA with a deaf seam of the bladder has better clinical efficacy and lower costs than TUR. To increase the efficiency of TUR additional DT may be required.