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September 9, 1992

Therapies for Benign Prostatic Hyperplasia

Author Affiliations

University of Manitoba Winnipeg, Manitoba, Canada

JAMA. 1992;268(10):1269-1270. doi:10.1001/jama.1992.03490100063027

The following letter was received after the authors had written their reply.—Ed.

To the Editor.  —Concato et al1 have meticulously studied "problems of comorbidity in mortality after prostatectomy." However, the issue is not resolved. In the only randomized trial of TURP vs open prostatectomy that has ever been reported, two of 32 patients died within 5 years of open prostatectomy, compared with nine of 43 patients following transurethral prostatectomy.2 This difference in proportions is statistically significant (P<.05) using a one-tailed t test. Recent studies have documented hemodynamic and cardiovascular changes during and subsequent to transurethral prostatectomy.3,4 Thus, the finding of increased mortality is no longer completely atheoretical.The comorbidity data used to adjust the relative risk (RR) of death following prostatectomy were collected uniformly and prospectively on 1650 men at the University of Manitoba, as reported in our first article.5 As these data