Our previous experience in other major laparoscopic procedures has allowed us to perform radical laparoscopic prostatectomy with a fast learning curve even in a setting of a relatively low population. Initial long term results seem similar to those achieved with conventional surgery.

We evaluate the cost and trends in the medical treatment of out patients suffering from lower urinary tract symptoms suggestive of clinical benign prostatic hyperplasia in Navarre (Spain) between 1998/2002. The estimated number of patients increased each year, to 10% of the male population over the age of 50 in 2002, with a cost of Euros 2,557,236 equivalent to 2.4% of the total drug expenditure spending of out patients (Euros 106.6 million). The use of tamsulosin tripled and the cost doubled to Euros 807,467 (31.5%) of the total), while the rest of alpha-blockers, wit the exception of doxazosin, was stationary. Phytotherapy decreased by a third and finasteride follows a slow upward trend. The introduction of reference prices set by the Health Department in 2001 to reduce medical budget, led to an initial decrease in cost, offsetted in the following year due to the incorporation of new patients. In this period, surgery for prostate adenoma diminished from 382 patients in 1998 to 270 in 2002 (-30%).

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