Extended LUTS medication use following BPH surgical treatment: a US healthcare claims analysis

Background: Postoperative medication use is an important yet relatively unexplored element of the benign prostatic hyperplasia patient journey. We assessed and compared the percentage of patients who required medication postoperatively after the three most common BPH surgeries in the real world: transurethral resection of the prostate (TURP), photovaporization procedure with GreenLight Laser (PVP), and prostatic urethral lift (PUL) with the UroLift system. Methods: Within a random representative sample of US Medicare and commercial insurance claims, patients with at least one year of follow-up data available after an outpatient TURP, PVP, or PUL procedure were linked to pharmaceutical claims to elucidate rates of continuous and de novo use of alpha-blockers, 5-alpha reductase inhibitors, or combination medical therapy. Periods of interest were perioperative (use within three months postoperatively and not beyond) and one and five years postoperatively. Results: 36 629 men diagnosed with BPH underwent outpatient TURP (n = 20 319), GreenLight PVP (n = 10 517) and PUL (n = 5 793) procedures within the claims dataset. The rate of medical therapy use through one year was lowest for PUL (4.1%) compared to TURP (6.2%) and PVP (6.6%), and was equivalent between procedures through five years (10.6% TURP, 10.4% PVP, and 10.3% PUL). Conclusions: Patients who undergo surgery to treat BPH may desire to discontinue or bypass BPH medications. However, these data demonstrated that approximately 10% of BPH patients used medication through five years postoperatively, regardless of which procedure they underwent.