Transition in Type of Surgery for Benign Prostatic Hyperplasia: A Multi-institutional Study in Japan.

OBJECTIVES This study compared the numbers and types of benign prostatic hyperplasia (BPH) surgeries performed in 2008 with those performed in 2003 to investigate changes in surgical procedures in Japan with the introduction of transurethral enucleation procedures. METHODS Forty-three hospitals in Japan participated in this study. We examined the numbers of patients undergoing BPH surgery in 2003 and 2008. Types of BPH surgery were divided into five categories: R (resection); E (enucleation); S (urethral stent); O (open surgery); and A (ablation or others). The participating hospitals were divided into two groups, those performing E surgery (E hospitals) and those which did not (Non-E hospitals). RESULTS The total numbers of BPH surgeries performed in all hospitals were 1610 in 2003 and 1720 in 2008. Of these, 1391 (86%) in 2003 and 1129 (66%) in 2008 were R-type, and 1 (<0%) in 2003 and 428 (25%) in 2008 were E-type. There were 17 E hospitals and 26 Non-E hospitals, and other characteristics of the hospitals were similar. In the E hospitals, the total number of BPH surgeries increased from 552 in 2003 to 776 in 2008. Conversely, that in Non-E hospitals decreased from 1058 in 2003 to 944 in 2008. The rate of R-type surgery was significantly lower in E hospitals than in Non-E hospitals, even in 2003 (73 vs 94%, P < 0.01). CONCLUSION E-type surgery increased considerably in the 5 years examined, but even in E hospitals, R-type surgery remained the main type of BPH surgery performed in 2008.