經尿道攝護腺刮除手術對於有攝護腺肥大症狀的中風患者依然能達到良好的治療效果：台灣健保資料庫分析
羅敏誠、侯鎮邦、林友翔、侯俊名、張慧朗、陳建綸、楊珮珊、崔克宏
長庚醫療財團法人林口長庚紀念醫院 泌尿外科
Transurethral resection of the prostate could still achieve favorable in stroke patients with symptomatic benign prostate hyperplasia : Implications from Taiwan nationwide population-based cohort study
Ming-Cheng Luo Chen-Pang Hou, Yu-Hsiang Lin, Chun-Ming Hou, Phei-Lang Chang, Chien-Lun Chen, Pei-Shan Yang, Ke-Hung Tsui.
Department of Urology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Purpose: The aim of this study was to compare the clinical outcomes between stroke patients and non-stroke patients receiving transurethral resection of prostate (TURP).
Materials and Methods: This analysis was a retrospective cohort study using 16 years (1997-2012) of claims data from Taiwan’s National Health Insurance Research Database (NHIRD). A total of 6625 patients who had persistent lower urinary tract symptoms (LUTS) and underwent TURP for benign prostate hyperplasia (BPH) were enrolled. They were divided into two cohorts: the stroke cohort (577 patients) and non-stroke cohort (6048 patients). The patients’ characteristics, post-operative clinical outcomes, medication records and the medical expenses were compared.
Results: The non-stroke cohort was younger in age and had less comorbidity. Although they had a better postoperative clinical outcomes compared to the stroke cohort. TURP still achieved favorable in stroke patients with symptomatic BPH. After the surgical procedure for the stroke group, the rate of UTI decreased from 34.7% during the pre-OP -1 year to 29.8% during the post-OP-1 year (p=0.05). The rate of UR also decreased from 55.5% during the pre-OP -1 year to 22.5% during the post-OP-1 year (p=0.05). In terms of medical economics, TURP reduced the overall medical expenses of stroke patients. Their yearly medical expense of pre-OP-1year, post-OP 1year, 2 year, and 3 year were 65.9k, 64.6k, 56.0k, and 59.9k New Taiwan Dollars, respectively.
Conclusions: Our study revealed that well-selected stroke patients would have benefits by receiving TURP. This procedure reduced the risk of UTI and UR. It could also reduce the yearly total medical expense in stroke patients.