PD5-05 USE OF ADDITIONAL THERAPY FOR BENIGN PROSTATIC HYPERPLASIA AFTER TURP AND LASER VAPORIZATION

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology II1 Apr 2015PD5-05 USE OF ADDITIONAL THERAPY FOR BENIGN PROSTATIC HYPERPLASIA AFTER TURP AND LASER VAPORIZATION Niraj Badhiwala, Adrienne Kuxhausen, Joel Vetter, and Seth Strope Niraj BadhiwalaNiraj Badhiwala More articles by this author , Adrienne KuxhausenAdrienne Kuxhausen More articles by this author , Joel VetterJoel Vetter More articles by this author , and Seth StropeSeth Strope More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.304AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES For men with moderate to severe lower urinary tract symptoms (LUTS) and significant bother from benign prostatic hyperplasia (BPH), transurethral resection of the prostate (TURP) or laser vaporization provide excellent symptomatic relief. While improvements in symptom scores, flow rates and post-void residual (PVR) are well documented for both TURP and laser vaporization procedures, less is known about medication use before and after these procedures. We compared the effectiveness of TURP and laser vaporization for removal of men from medical therapy and avoidance of further medical or surgical therapy. METHODS We examined all men treated at our institution for LUTS related to BPH from 2008 through 2013 with TURP or laser vaporization. Controlling for age, BMI, comorbidity, pre-surgical use of BPH medications (alpha-blocker, AR, antispasmodic), AUA symptom score, post void residual, and evidence of obstruction in predicting failure of surgery, we examined continued use of medical therapy 1–6 months after surgery with logistic regression analysis and long-term follow up for new medical or surgical therapy with Cox-proportional hazards regression. RESULTS We treated 454 men between 2008 through 2013 (277 TURP, 277 Laser vaporization). 330 men had postoperative follow-up between 1 and 6 months (167 TURP, 163 Laser) with 50% of patients showing continued medication use in each group (OR 1.03 CI 0.63, 1.68). Laser and TURP patients were equally likely to have long term failure (HR 1.65 CI 0.83, 3.29), with pre-operative use of anticholinergic medications significantly associated with long-term failure (2.73 CI 1.05, 7.06). CONCLUSIONS Significant number of men remained on medication for LUTS after surgery for BPH. There was no difference in post-surgical medication use between men undergoing TURP vs laser vaporization. Men on anti-spasmodic medications before surgery are more likely to have repeat medical or surgical therapy for BPH. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e93-e94 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Niraj Badhiwala More articles by this author Adrienne Kuxhausen More articles by this author Joel Vetter More articles by this author Seth Strope More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...