Startsev V Yu, Dudarev V A, Sevryukov F A, Zabrodina N B
Department of Oncology, Pediatric Oncology and Radiation Therapy FGBOU VO Saint-Petersburg State Pediatric Medical University, Saint-Petersburg, Russia.
FGBNU Institute of Experimental Medicine of Russian Academy of Science, Saint-Petersburg, Russia.
Urologiia. 2019 Dec 31(6):115-119.
A review of the literature dedicated to the economic aspects of drug and surgical treatment of lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) is presented in the article. Currently, symptomatic therapy, which usually leads to an increase in the financial costs associated with the complications and surgical treatment, is most commonly used. The pathogenetic treatment of BPH (5-alpha reductase inhibitors), including combination therapy, requires an increase in costs, but it is also considered the most cost-effective approach. Despite the continuous growing of therapeutic armamentarium, the surgical treatment is still relevant and holds an important place. A lot of studies have shown that open procedures are inferior to endoscopic and minimally invasive interventions by both clinical and cost-effective results. At the same time, transurethral interventions on the prostate does not exclude economic losses due to the necessity of expensive laser technologies and the development of complications in the early postoperative period. Thus, currently, the best treatment option should be chosen not only on individual basis, but also depending on economic aspects based on a balanced medical and economic analysis of each treatment method.
本文对致力于良性前列腺增生（BPH）相关下尿路症状（LUTS）药物及手术治疗经济方面的文献进行了综述。目前，最常用的是对症治疗，这通常会导致与并发症及手术治疗相关的财务成本增加。BPH的病因治疗（5-α还原酶抑制剂），包括联合治疗，需要增加成本，但它也被认为是最具成本效益的方法。尽管治疗手段不断增加，但手术治疗仍然具有相关性且占据重要地位。许多研究表明，无论是临床效果还是成本效益结果，开放手术都不如内镜及微创干预。同时，前列腺经尿道干预由于昂贵的激光技术需求以及术后早期并发症的发生，也无法避免经济损失。因此，目前，最佳治疗方案不仅应根据个体情况选择，还应基于对每种治疗方法的医学与经济平衡分析，依据经济因素来决定。
