De La Rosette J J M C H, Floratos D L, Severens J L, Kiemeney L A L M, Debruyne F M J, Pilar Laguna M
Department of Urology, Academic Medical Centre, Amsterdam, the Netherlands.
BJU Int. 2003 Nov;92(7):713-8. doi: 10.1046/j.1464-410x.2003.04470.x.
To compare the costs and outcome of high-energy transurethral microwave thermotherapy of the prostate (HE-TUMT) with transurethral resection of the prostate (TURP), as the former is considered to be the best minimally invasive method for managing lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH).
Between January 1996 and March 1997, 144 patients were randomized to treatment with HE-TUMT (78) using the Prostatron device and Prostasoft 2.5 software (EDAP Technomed, Lyon, France), or TURP (66). At baseline and during the annual follow-up, patients were evaluated by the International Prostate Symptom Score and uroflowmetry (maximum flow rate and postvoid residual volume). Kaplan-Meier survival analyses were used to calculate the cumulative risk of re-treatment. A cost-consequences analysis was performed based on the prospective measurement of healthcare use, with costs expressed as Netherland guilders (NLG).
During a 3-year follow-up period, the mean (95% confidence interval) risk of re-treatment was 22.9 (12.5-33.2)% and 13.2 (4.5-21.9)% for HE-TUMT and TURP, respectively (P = 0.215). The mean direct cost of treatment was 3450 (3444-3456) and 6560 (5992-7128) NLG for HE-TUMT and TURP, respectively. The mean total (including re-treatments), discounted (4%) 3-year cost for the HE-TUMT and TURP group was 5300 (4692-5908) and 7800 (7118-8482) NLG, respectively.
In this prospective randomized trial, HE-TUMT and TURP had a comparable 3-year risk of re-treatment. Healthcare expenditure on HE-TUMT, mainly because it is an outpatient treatment, was significantly lower than for TURP.
比较高能经尿道前列腺微波热疗（HE-TUMT）与经尿道前列腺切除术（TURP）的成本和治疗效果，因为前者被认为是治疗提示良性前列腺增生（BPH）的下尿路症状（LUTS）的最佳微创方法。
1996年1月至1997年3月期间，144例患者被随机分为两组，分别接受使用Prostatron设备和Prostasoft 2.5软件（法国里昂EDAP Technomed公司）进行的HE-TUMT治疗（78例）或TURP治疗（66例）。在基线和年度随访期间，通过国际前列腺症状评分和尿流率测定（最大尿流率和排尿后残余尿量）对患者进行评估。采用Kaplan-Meier生存分析计算再次治疗的累积风险。基于对医疗保健使用情况的前瞻性测量进行成本后果分析，成本以荷兰盾（NLG）表示。
在3年的随访期内，HE-TUMT组和TURP组再次治疗的平均（95%置信区间）风险分别为22.9（12.5 - 33.2）%和13.2（4.5 - 21.9）%（P = 0.215）。HE-TUMT组和TURP组的平均直接治疗成本分别为3450（3444 - 3456）NLG和6560（5992 - 7128）NLG。HE-TUMT组和TURP组的平均总（包括再次治疗）、贴现（4%）3年成本分别为5300（4692 - 5908）NLG和7800（7118 - 8482）NLG。
在这项前瞻性随机试验中，HE-TUMT和TURP的3年再次治疗风险相当。HE-TUMT的医疗保健支出，主要因为它是门诊治疗，显著低于TURP。
