National trends in surgical therapy for benign prostatic hyperplasia in Australia

Over the last 20 years there have been substantial changes in the surgical management of benign prostatic hypertrophy in Australia. Over this time, surgical procedures have increased by 79%; TURP procedures have decreased from 96% to 73% and have been replaced by laser prostatectomy and UroLift procedures. There is substantial variation in utilisation of surgical procedures between the states.

Background

To determine national trends in the utilization of surgical procedures for the treatment of benign prostatic hyperplasia (BPH) in Australia over the last 20 years.

Methods

The Medicare Australia and Australian Institute of Health and Welfare databases were used to determine the annual number of surgical procedures and hospital admissions for BPH.

Results

From 1998 to 2017, surgical procedures for BPH have increased by 79% which is largely commensurate with population growth. From 1998 to 2008, transurethral resection of the prostate (TURP) was the predominant surgical therapy, accounting for 96% of all surgical treatments. From 2008 to 2017, TURP use reduced to 70% and in the last 5 years has been replaced with photoselective vaporization (16%), UroLift (8%) and holmium laser prostatectomy (6%). UroLift is used significantly more in younger men (P < 0.001).

Conclusion

There has been a substantial increase in surgical treatments for BPH over the last 20 years. In the last 5 years, TURP use has declined due to an increase in laser prostatectomy and UroLift procedures.

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