PD26-12 USE OF MEDICAL THERAPY AND SUCCESS OF LASER SURGERY AND TURP FOR BPH

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology I1 Apr 2014PD26-12 USE OF MEDICAL THERAPY AND SUCCESS OF LASER SURGERY AND TURP FOR BPH Seth Strope, Joel Vetter, Sean Elliott, Gerald Andriole, and Margaret Olsen Seth StropeSeth Strope More articles by this author , Joel VetterJoel Vetter More articles by this author , Sean ElliottSean Elliott More articles by this author , Gerald AndrioleGerald Andriole More articles by this author , and Margaret OlsenMargaret Olsen More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2099AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES For men with LUTS, surgical intervention provides excellent symptom management. However, utilization of medical therapy around surgery is not well characterized. We assessed the pre- and post-operative utilization of BPH related medications among surgically treated men. METHODS Using the Truven Health Analytics MarketScan® Commercial Claims Database, a database of commercially insured patients, we defined a cohort of men, < 65 years of age, who had surgical therapy for LUTS with either TURP or laser procedures from 2007 through 2009. We assessed outpatient medication use (5-ARIs, alpha blockers, anticholinergics) for one year prior to surgery through 4 months after surgery. Types of medications used were compared before and 4 months after surgery by chi-square testing. We then compared TURP and laser procedures for the proportion of patients who failed surgery (defined as use of medication at 4 months after the index procedure or repeat surgical procedure within four months after the index procedure). RESULTS We identified 6500 patients who were treated with either TURP (3404 patients) or a laser procedure (3096 patients) for BPH. We found no difference in the proportion of patients using BPH medication at the time of surgery (46% TURP, 47% laser, p = 0.38). After surgery, TURP patients were significantly less likely to be on medical therapy (16% versus 20%; p < 0.001). While most patients were on no medication by 4 months post surgery, use of antispasmodic medication increased among both laser and TURP patients (Figure). By 4 months after surgery, patients who received laser therapy were significantly more likely to have had a failure event than TURP patients (21% failures laser; 16% failures TURP; p = 0.001). CONCLUSIONS Most patients who receive surgical therapy for BPH are not current users of medical therapy for LUTS. However, a significant proportion of patients are using medical therapy 4 months after surgical intervention, with laser therapy associated with increased risk of such failure. These results suggest men need to be counseled on the possibility of continued or new medical therapy after surgical intervention for LUTS. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e763-e764 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Seth Strope More articles by this author Joel Vetter More articles by this author Sean Elliott More articles by this author Gerald Andriole More articles by this author Margaret Olsen More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...