Medical therapy versus transurethral resection of the prostate (TURP) for the treatment of symptomatic benign prostatic enlargement (BPE): a cost minimisation analysis

Research output: Contribution to journalArticle


Purpose: A cost minimisation analysis compares the costs of different interventions’ to ascertain the least expensive over time. We compared different prostate targeted drug treatments with TURP to identify the optimal cost saving duration of a medical therapy for symptomatic benign prostatic enlargement (BPE). Methods: The Evolution registry is a prospective, multicentre registry, conducted by the European Association of Urology Research Foundation (EAUrf) for 24 months in 5 European countries. Evolution was designed to register the management of symptomatic BPE in clinical practice settings in 5 European countries. Direct cost evaluation associated with prostate targeted medical therapies and TURP was also recorded and analysed. Results: In total, 1838 men were enrolled with 1246 evaluable at 24 months. Medical therapies were more cost saving than TURP for treatment durations ranging from 2.9 to 70.4 years. Cost saving depended on both medication class and individual country assessed. Daily tamsulosin monotherapy was more cost saving than TURP for ≤ 13.9 years in Germany compared to ≤ 32.7 years in Italy. Daily finasteride monotherapy was more cost saving for ≤ 5.9 years in France compared to ≤ 36.9 years in Spain. Combination therapy was more cost saving for ≤ 5.9 years for Italian patients versus ≤ 13.8 years in Germany. Conclusions: BPE medical management was more cost saving than TURP for different specific treatment durations. Information from this study will allow clinicians to convey medical and surgical costs over time, to both patients and payors alike, when considering BPE treatment.


  • Niall F. Davis
  • G. S. Jack
  • W. P. Witjes
  • A. Bjartell
  • C. Caris
  • A. Patel
  • A. de la Taille
  • N. Lawrentschuk
  • D. M. Bolton
  • A. Tubaro
External organisations
  • Austin Hospital
  • Sapienza University of Rome
  • European Association of Urology, Research Foundation
  • Spire London East Hospital
  • Assistance Publique des Hôpitaux de Paris
  • Sant'Andrea Hospital
  • Skåne University Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Urology and Nephrology


  • Benign prostatic enlargement, Benign prostatic hyperplasia, BPE, BPH, Cost minimisation analysis
Original languageEnglish
Pages (from-to)873-878
JournalWorld Journal of Urology
Issue number5
Early online date2018 Aug 25
Publication statusPublished - 2019
Publication categoryResearch