Investig Clin Urol.  2016 Nov;57(6):424-430. 10.4111/icu.2016.57.6.424.

Nationwide incidence and treatment pattern of benign prostatic hyperplasia in Korea

• Lee YJ
• Lee JW
• Park J
• Seo SI
• Chung JI
• Yoo TK
• Son H

• KMID: 2451401
• DOI: http://doi.org/10.4111/icu.2016.57.6.424

Abstract

PURPOSE
To investigate the incidence of benign prostatic hyperplasia (BPH) in Korea and treatment patterns for 3 years after the diagnosis in a nationwide database.
MATERIALS AND METHODS
We created a cohort of patients diagnosed of BPH between 2007 and 2011 from the Health Insurance Review & Assessment database, a nationwide database of reimbursement. The diagnosis of BPH was defined as having the diagnosis of BPH (N40.0 in International Classification of Diseases, 10th revision) as a primary or secondary diagnosis ≥2 times in 2008. The incidence of BPH in 2008 was calculated. Treatment patterns were determined in 3 months interval and traced for 3 years. The incidence and timing of surgery were also determined. For patients taking medications preoperatively, medication-free rate was calculated.
RESULTS
The incidence of BPH was 2,105 per 100,000 men (mean age, 59.7±11.4 years), and increased with age. Surgery was performed for 7,955 patients (2.1%), half of the surgery being performed within the first 6 months. Transurethral resection of the prostate was the most commonly performed surgery. The proportion of treatment increased with age until the 7th decade of life. The patients taking medication for >1 year after the initial diagnosis was 21.4%. On average, 82% of patients became medication-free at postoperative 1 year. For patients taking preoperative anticholinergics, 1 year medication-free rate was 73.3%.
CONCLUSIONS
The incidence of BPH increased with age. Surgery was performed in 2.1% of patients. More than 4/5 patients discontinued medication after surgery, while patients taking preoperative anticholinergics were less likely to.

Keyword

Epidemiology; Lower urinary tract symptoms; Prostatic hyperplasia; Time-to-treatment

MeSH Terms

Adult
Age Distribution
Aged
Aged, 80 and over
Databases, Factual
Drug Utilization/statistics & numerical data
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Prostatectomy/methods/utilization
Prostatic Hyperplasia/*epidemiology/*therapy
Republic of Korea/epidemiology
Urological Agents/therapeutic use

Figure

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  Fig. 1 The incidence and distribution of benign prostatic hyperplasia (BPH). (A) The incidence of BPH (/100,000 persons) in 2008 according age group, (B) regional distribution, and (C) the type of hospital.

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  Fig. 2 Treatment trends according to age.

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  Fig. 3 Cumulative incidence of benign prostatic hyperplasia surgery after diagnosis at 3-month intervals. (A) Cumulative incidence, (B) cumulative incidence stratified by type of surgery. TURP, transurethral resection of the prostate; Open P, open prostatectomy; PVP, photoselective vaporization of the prostate; HoLEP, holmium laser enucleation of prostate.

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  Fig. 4 Incidence and type of surgical treatment during the 3 years of follow-up. TURP, transurethral resection of the prostate; PVP, photoselective vaporization of the prostate; Open P, open prostatectomy; HoLEP, holmium laser enucleation of prostate.

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  Fig. 5 Postoperative medication status of patients during the 3 years of follow-up. (A) Transurethral resection of the prostate, (B) photoselective vaporization of the prostate, (C) open prostatectomy, and (D) thermal therapy. A, alpha-blockers; B, 5-alpha reductase inhibitors; C, anticholinergics.

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