BPH Treatment in General Hospital Šibenik and pharmacological impact on BPH therapy in Šibensko-kninska County; fourteen years retrospective study from 2000 to 2013

D. Reljić, M.Paić, A.Mojsović, M. Bošnjak, M.Selimović,

Department of Surgery and Urology, General Hospital Šibenik, Croatia


Introduction : Lower urinary tract symptoms (LUTS) represent one of the most common clinical complaints in adult men. The prevalence of LUTS increases with ageing and traditionally been related to bladder outlet obstruction (BOO) as a result of benign prostatic obstruction (BPO), which is often associated with benign prostatic enlargement resulting from the histological condition of benign prostatic hyperplasia (BPH). Mainly because constant ageing of male population BPH today represent great impact on public health care systems by number of patients and cost of they treatment. Urological unit of General Hospital Šibenik covered Šibensko-kninska County of Republic Croatia with 110.000 habitants.

Methods: We have made retrospective analysis of database General Hospital Šibenik connected with surgical treatment of benign prostatic hyperplasia in time from January 2000 to December 2013 and also compared number of open classical transvesical adenemectomy (secundum Freyer ) with number of transurethral resection of prostate (TURP ) in same period.

We analyzed quantity of prescribed selective α-1 blockers and 5-α reductase inhibitors (5-ARIs) in Šibensko-kninska County and they impact on frequency and type of surgical treatments benign prostatic hyperplasia in General Hospital Šibenik.

Results: From the January 2000 until December 2013 in General Hospital Šibenik has been surgically treated 822 patients with BPH. From 2000 until today we recorded constantly decreased of numbers of surgical procedures for treatment BPH. Number of both surgical procedures, transvesical adenectomy and transurethral resection of prostate are in decreasing, but in percentage transurethral resection of prostate are in growth compared with transvesical adenemectomy.

Conclusion: Introducing 5-α reductase inhibitors (5-ARIs) in treatment BPH during last decade of XX century, introducing first non selective and after selective α-1 blockers in beginning of XXI century and especially after starting using dual therapy need for surgical treatment of benign prostatic hyperplasia are dramatically reduced. What we can expect in nearest future?