OBJECTIVE: To assess the temporal trend in surgical treatment of benign hypertrophy of the prostate in Sweden, particularly the possible influence of nocturia on the probability to be treated by a transurethral resection operation of the prostate (TURP). MATERIALS AND METHODS: There were 2501 elderly men recruited by a questionnaire from a group of pensioners (n=4035; response rate 62%). Their age was 73.3 (6.4) years. The questionnaire included questions on their health and diseases, drugs, sleep habits and the number of nocturnal voiding episodes. Data on deaths from July 1, 1992 to December 31, 1997 were obtained.
RESULTS: During the study period 176 TURPs had been performed on 170 men (annual incidence of first TURP: 12.4 treatments/1000 men). The annual rate of TURP was 8.4 treatments/1000 men at ages under 69 years, in men at ages 70-74 years 15.7 and in men 75 years and older 12.7 treatments/1000 men, respectively (p < 0.05). When divided in two time periods of equal length (33 months), 107 (14.1 treatments/1000 men/year) TURPs were performed during the first time period (P1), and 63 (8.6 treatments/1000 men/year) were performed during the second period (P2), (OR P2 vs. P1: 0.59; CI 0.43-0.81). During P1, but not during P2, there was an increase in TURP frequency number in relation to the number of nocturnal micturitions (p < 0.0001).
CONCLUSIONS: TURPs decreased by 41% from P1 to P2. During P1 the occurrence of nocturia showed a significant influence of the probability to be subjected to TURP. No such tendency was recorded during P2.