Mp62-13 Long-Term Medication Use After Surgical Treatment for Bladder Outlet Obstruction, How Does Holep Compare to Other Surgical Modalities?

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology IV (MP62)1 May 2024MP62-13 LONG-TERM MEDICATION USE AFTER SURGICAL TREATMENT FOR BLADDER OUTLET OBSTRUCTION, HOW DOES HOLEP COMPARE TO OTHER SURGICAL MODALITIES? Talia A. Helman, Dattatraya Patil, Siddarth Marthi, and Brendan Browne Talia A. HelmanTalia A. Helman , Dattatraya PatilDattatraya Patil , Siddarth MarthiSiddarth Marthi , and Brendan BrowneBrendan Browne View All Author Informationhttps://doi.org/10.1097/01.JU.0001008904.63948.3b.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS) are common conditions in the aging male population. While behavioral modifications and medical therapies remain firstline, many patients wish to reduce chronic medication use and opt for surgery. Some have recurrence of LUTS requiring resumption of medication. This study evaluates BPH medication resumption after bladder outlet obstruction (BOO) procedures. METHODS: This longitudinal, retrospective, population-based cohort study used MarketScan Database to capture US commercial insurance claims. Starting in 2009, men >35 years with diagnosis of BPH or LUTS and minimum 5 years continuous insurance coverage since diagnosis were included. BPH medication retreatment was defined as a minimum 90 day prescription after index surgery. We compared holmium laser enucleation of prostate (HoLEP) to other hospital procedures; holmium laser ablation of prostate (HoLAP), transurethral resection of prostate (TURP), and simple prostatectomy (SP), and office procedures; transurethral microwave thermotherapy (TUMT), transurethral needle ablation (TUNA), water vaporization (Rezum), and prostatic urethral lift (PUL). Multivariable Cox hazard models (p<0.01) were used to evaluate factors associated with medical retreatment after surgery. RESULTS: Of those who were diagnosed with BPH or LUTS from 2009 and 2017 and who met the defined insurance criteria, 11,120 received surgical treatment for BOO. Overall, median days to restart medication was 42 days (range 15-199). When compared to HoLEP, office (hazard ratio [HR]: 2.70, 95% confidence interval [CI]: 2.20-3.31, p<0.001) and other hospital procedures (HR 1.72, 95% CI: 1.41-2.10), p=0.001) were more likely to restart long-term (>90 days) medication. Cumulative incidence of restarting medication within 1 year of surgery was 45.5%, 32.5%, and 22.7% for office, hospital, and HoLEP (Figure 1). CONCLUSIONS: Resumption of medication is common after BOO procedures. When compared to other modalities, HoLEP is significantly less likely to require medical retreatment. As office procedures become more common, it is important to counsel patients that more than 40% will restart BPH medication within 1 year after surgery. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1026 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Talia A. Helman More articles by this author Dattatraya Patil More articles by this author Siddarth Marthi More articles by this author Brendan Browne More articles by this author Expand All Advertisement PDF downloadLoading ...