Incidence of acute myocardial infarction and cause-specific mortality after transurethral treatments of prostatic hypertrophy.
OBJECTIVE
Transurethral resection of the prostate (TURP) is associated with a higher long-term mortality than open prostatectomy which has been ascribed to a higher incidence of acute myocardial infarction (AMI). To assess the possible excess risk associated with TURP, we studied the incidence of AMI and the cause-specific mortality in patients treated with TURP and transurethral microwave thermotherapy (TUMT).


METHODS
Patients treated for benign prostatic hypertrophy at a university hospital (888 patients with TURP and 478 with TUMT) were monitored during an average follow-up period of 3.9 years. The incidence of AMI and the causes of death were compared with those in the general population.


RESULTS
Both treatments were followed by a higher incidence of AMI than in the general population, in particular from 2 years or more after treatment (standardized morbidity ratio 1.50, 95% confidence interval [CI] 1.14 to 1.93). The long-term mortality from all causes was increased in patients younger than 75 years of age when undergoing any of the treatments (standardized mortality ratio [SMR] 1.16, 95% CI 0.97 to 1.39), in particular, death from cardiovascular diseases (SMR 1.25, 95% CI 0.95 to 1.60) and tumors (SMR 1.54, 95% CI 1.14 to 2.03).


CONCLUSIONS
The similarity of the results for TURP and TUMT suggests that the prostatic enlargement rather than the treatment is associated with cardiovascular disease.
Hahn
R G
RG
Karolinska Institutet at Söder Hospital, Stockholm, Sweden.
Farahmand
B Y
BY
Hallin
A
A
Hammar
N
N
Persson
P G
PG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D015331:Cohort Studies; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects* / Q000379:methods; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology*; D011470:Prostatic Hyperplasia / Q000401:mortality* / Q000601:surgery*; D012306:Risk; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D020728:Transurethral Resection of Prostate / Q000009:adverse effects*