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—We endorse research intended to evaluate the effectiveness of therapies for BPH. A randomized trial comparing TURP vs open prostatectomy, however, may be unfeasible. Many urologists—and their patients—would shun the more invasive "open" procedure for the reasons listed by Dr Mebust. Accordingly, future trials may determine how TURP compares with newer treatment modalities, but will not address the issues investigated in our article. If the "prospective" research is an observational cohort, we hope it will avoid the statistical problems of claims data by giving adequate attention to the appraisal of severity for both the prostatic ailment and the comorbid diseases.
Concato J, Horwitz RI, Feinstein AR, Elmore JG, Schiff SF. Therapies for Benign Prostatic Hyperplasia-Reply. JAMA. 1992;268(10):1269. doi:10.1001/jama.1992.03490100063026