Bisonni R S, Lawler F H, Holtgrave D R
Department of Family Medicine, Oklahoma University Health Sciences Center, Oklahoma City 73190.
Fam Pract Res J. 1993 Mar;13(1):25-36.
Transurethral prostatectomy is the treatment currently preferred for benign prostatic hyperplasia. A new procedure, transurethral dilatation of the prostatic urethra, has lower costs and mortality and complication rates but may be less effective. These two strategies were evaluated by using cost-utility analysis, a form of cost-effectiveness analysis in which the benefit is defined in terms of individual preferences. Under the model assumptions, the cost of transurethral dilatation is less than the cost of transurethral prostatectomy for patients with benign prostatic hyperplasia ($7084 versus $8647) and slightly more effective: 11.787 quality adjusted life years versus 11.766. Thus, transurethral prostatectomy is said to be dominated. Results indicate that if patients are rigorously selected, and if balloon catheters of 30-35mm in size are utilized, transurethral dilatation could be the initial treatment of choice for eligible patients with benign prostatic hyperplasia.
经尿道前列腺切除术是目前治疗良性前列腺增生的首选方法。一种新的手术方法，即经尿道前列腺尿道扩张术，成本更低，死亡率和并发症发生率也较低，但可能效果稍差。通过使用成本效用分析对这两种策略进行了评估，成本效用分析是成本效益分析的一种形式，其中效益是根据个人偏好来定义的。在模型假设下，对于良性前列腺增生患者，经尿道扩张术的成本低于经尿道前列腺切除术（分别为7084美元和8647美元），且效果略好：质量调整生命年分别为11.787和11.766。因此，经尿道前列腺切除术被认为处于劣势。结果表明，如果对患者进行严格筛选，并且使用尺寸为30 - 35毫米的球囊导管，经尿道扩张术可能成为符合条件的良性前列腺增生患者的首选初始治疗方法。
