Therapies for Benign Prostatic Hyperplasia

To the Editor. —The article by Concato et al¹in the February 26, 1992, issue ofJAMAthat sheds additional light on the subject of mortality associated with transurethral resection of the prostate (TURP) is of great importance to many physicians and their patients. The number of men in the United States seeking treatment for benign prostatic hyperplasia (BPH) continues to grow, currently accounting for an estimated 1.7 million physician-office visits annually. As the article reports, approximately 350 000 surgeries were performed in 1986,95% of them TURPs. The estimated annual costs for these procedures is $3 billion. As the population continues to age, these numbers can only increase significantly. Most urologists associate TURP as the most appropriate medical procedure for treating BPH. This is because TURP effectively reduces any obstruction, alleviates a patient's symptoms, and improves quality of life. In addition, the medical community has long associated TURP with