Five-year Retreatment and Medication Restart Rates Following Benign Prostate Hyperplasia Treatments: A Nationwide...

Area of Science:

• Urology
• Surgical Innovation
• Health Outcomes Research

Background:

• Benign prostatic hyperplasia (BPH) treatments are evolving with minimally invasive surgical treatments (MISTs).
• Long-term durability of MISTs compared to traditional procedures remains a concern.
• Real-world data is crucial for understanding current BPH treatment trends and outcomes.

Purpose of the Study:

• To describe current BPH treatment trends, including procedural uptake.
• To evaluate retreatment rates following MISTs and traditional surgical procedures up to 5 years.
• To assess medication reinitiation rates after various BPH treatments.

Main Methods:

• An observational, retrospective, fixed-cohort study using Epic Cosmos data (2014-2024).
• Included over 6.4 million patients and 420,000 procedures.
• Analyzed procedural trends, retreatment, and medication reinitiation rates descriptively.

Main Results:

• Anatomical procedures (HoLEP/ThuLEP, simple prostatectomy) had lower retreatment rates (1.2%-4.4%) than TURP (7.1%) and MISTs (14%-17%) at 5 years.
• Medication reinitiation was more common after MISTs (e.g., PUL, Rezūm) compared to traditional procedures.
• Transurethral resection of the prostate (TURP) was the most frequently performed procedure.

Conclusions:

• Anatomical procedures demonstrate superior long-term durability regarding retreatment and medication use compared to MISTs.
• MISTs, particularly Prostatic Urethral Lift (PUL) and Rezūm, showed higher retreatment and medication reinitiation rates.
• Further research is needed to identify patient characteristics influencing these outcome differences.