Incidence of acute myocardial infarction and cause-specific mortality after transurethral treatments of prostatic hypertrophy

Objectives. 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 TURF, we studied the incidence of AMI and the cause-specific mortality in patients treated with TURF and transurethral microwave thermotherapy (TUMT). Methods. Patients treated for benign prostatic hypertrophy at a university hospital (888 patients with TURF 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 1.95). 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 TURF and TUMT suggests that the prostatic enlargement rather than the treatment is associated with cardiovascular disease. (C) 2000, Elsevier Science inc.