📃 Paper Title: A comparison of transurethral surgery with watchful waiting for moderate symptoms of benign prostatic hyperplasia. The Veterans Affairs Cooperative Study Group on Transurethral Resection of the Prostate
🧍 Author: Wasson
🕒 Year: 1995
📚 Journal: New England Journal of Medicine
🌎 Country: United States of America
ㅤContext to the study:
Are there any papers that have shown that TURP is an effective surgical treatment for BPH?
ㅤ✅ Take-home message of study:
TURP is more effective than watchful waiting to treat men with moderate or bothersome BPH symptoms. Watchful waiting is a safe alternative for men less bothered by urinary symptoms or who want to delay surgery
ㅤ Single-centre, randomised trial
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Study participants:
Inclusion:
Men over 54 years
Moderate Urinary Symptoms Score (10-20) on a score of 0-27
Exclusion:
Prior BPH surgery
556 men were randomly assigned to the surgical (n=280) or watchful waiting (n=276) group
The average follow-up period was 2.8 years
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Key study outcomes:
The primary outcome was treatment failure (urinary retention, CKD, post-void residual >350mls, bladder calculus, high symptom score). Treatment failure occurred in 23 patients in the surgical group compared to 47 in the watchful waiting group (RR: 0.48 95% CI: 0.30-0.77). Outcomes for surgery were best for men most bothered by urinary symptoms at baseline
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Study Limitations:
The definition of moderate LUTS is loosely defined by the symptom score
The incidence of treatment failure is so low in this study no meaningful secondary analyses can be undertaken
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