Factors Associated With Continuing Medical Therapy After Transurethral Resection of Prostate

Han, Hyunho; Ko, Woo Jin; Yoo, Tag Keun; Oh, Tae Hee; Kim, Duk Yoon; Kwon, Dong Deuk; Byun, Seok‐Soo; Kim, Sun Il; Jung, Tae Young

doi:10.1016/j.urology.2014.04.027

Cited by 43 publications

(41 citation statements)

References 22 publications

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“…Single institution studies have provided some information on use of medications after surgery, and consistent with our study found many men were not on medications prior to intervention and many men continued medical therapy after the procedure. 17 Our study expands on these prior results in a population-based framework.…”

Section: Discussionsupporting

confidence: 52%

Use of Medical Therapy and Success of Laser Surgery and Transurethral Resection of the Prostate for Benign Prostatic Hyperplasia

Strope

Vetter

Elliott

et al. 2015

Urology

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Objective To assess the impact of surgery for BPH on use of medication (5-ARIs, alpha blockers, antispasmodics), we assessed pre- and post-operative medication utilization among surgically treated men. Materials and Methods Using the Truven Health Analytics MarketScan® Commercial Claims Database, we defined a cohort of men < 65 years of age who had surgical therapy for BPH with either TURP or laser procedures from 2007 through 2009. Primary outcomes included freedom from medical or surgical intervention by 4 months after surgery (chi-square and multivariable logistic regression) and subsequent use of medical or surgical intervention in initial responders (Kaplan-Meier and multivariable Cox regression). Results We identified 6430 patients treated with either TURP (3096) or laser procedure (3334) for BPH. Pre-surgical antispasmodic use was associated with the highest risk of medication use at 4 months after surgery (OR 5.19; CI 3.16 to 8.53 versus no medication use prior to surgery). At three years after surgery, 6% (95% CI 4–8%) of laser and 4% (95% CI 2–5%) of TURP treated patients had repeat surgical intervention, and both laser and TURP treated patients had an estimated new use of medication rate of 22% (95% CI 18–25% laser and 20–25% TURP). The strongest predictor of intervention after surgery was pre-operative antispasmodic use (HR 2.49; 95% CI 1.41 to 4.43). Conclusions Our results show a need for effective patient counseling about continued or new use of medical therapy after laser and TURP procedures. However, most patients experience durable improvement after surgical intervention for BPH.

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Section: Discussionsupporting

confidence: 52%

Use of Medical Therapy and Success of Laser Surgery and Transurethral Resection of the Prostate for Benign Prostatic Hyperplasia

Strope

Vetter

Elliott

et al. 2015

Urology

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“…A certain portion of patients continued medication after BPH surgery. As Han et al [19] showed that older age, the presence of comorbidities, and preoperative anticholinergic usage could be associated with the continuation of medication after TURP. Although detailed clinical information regarding the voiding status and the size of prostates could not be identified from this data, it is still meaningful considering the scarcity of nationwide data containing information on both prescriptions and surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

Nationwide incidence and treatment pattern of benign prostatic hyperplasia in Korea

Lee

Park

et al. 2016

Investig Clin Urol

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PurposeTo investigate the incidence of benign prostatic hyperplasia (BPH) in Korea and treatment patterns for 3 years after the diagnosis in a nationwide database.Materials and MethodsWe created a cohort of patients diagnosed of BPH between 2007 and 2011 from the Health Insurance Review & Assessment database, a nationwide database of reimbursement. The diagnosis of BPH was defined as having the diagnosis of BPH (N40.0 in International Classification of Diseases, 10th revision) as a primary or secondary diagnosis ≥2 times in 2008. The incidence of BPH in 2008 was calculated. Treatment patterns were determined in 3 months interval and traced for 3 years. The incidence and timing of surgery were also determined. For patients taking medications preoperatively, medication-free rate was calculated.ResultsThe incidence of BPH was 2,105 per 100,000 men (mean age, 59.7±11.4 years), and increased with age. Surgery was performed for 7,955 patients (2.1%), half of the surgery being performed within the first 6 months. Transurethral resection of the prostate was the most commonly performed surgery. The proportion of treatment increased with age until the 7th decade of life. The patients taking medication for >1 year after the initial diagnosis was 21.4%. On average, 82% of patients became medication-free at postoperative 1 year. For patients taking preoperative anticholinergics, 1 year medication-free rate was 73.3%.ConclusionsThe incidence of BPH increased with age. Surgery was performed in 2.1% of patients. More than 4/5 patients discontinued medication after surgery, while patients taking preoperative anticholinergics were less likely to.

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“…Additionally, the post-operative IPSS and QoL were not satisfying. Han et al [19] assessed which medications were used after TURP and found that many patients had persistent voiding dysfunction after surgical treatment for LUTS/BPH. Older age, history of diabetes, history of cerebrovascular accidents and preoperative antimuscarinic drug use were determined to be possible risk factors.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of 5α-reductase inhibitors for patients with large benign prostatic hyperplasia (>80 mL) after transurethral resection of the prostate

Qian

Yu³

et al. 2015

The Aging Male

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Factors Associated With Continuing Medical Therapy After Transurethral Resection of Prostate

Cited by 43 publications

References 22 publications

Use of Medical Therapy and Success of Laser Surgery and Transurethral Resection of the Prostate for Benign Prostatic Hyperplasia

Use of Medical Therapy and Success of Laser Surgery and Transurethral Resection of the Prostate for Benign Prostatic Hyperplasia

Nationwide incidence and treatment pattern of benign prostatic hyperplasia in Korea

Efficacy of 5α-reductase inhibitors for patients with large benign prostatic hyperplasia (>80 mL) after transurethral resection of the prostate

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