Rates and Predictors of Persistent LUTS Medication Use After Laser Enucleation of the Prostate

Area of Science:

• Urology
• Pharmacology

Background:

• Lower urinary tract symptoms (LUTS) significantly impact quality of life.
• Medications are commonly prescribed for LUTS management.
• Laser enucleation of the prostate (LEP) is a common surgical treatment for benign prostatic hyperplasia.

Purpose of the Study:

• To evaluate the trends in LUTS medication use post-LEP.
• To identify preoperative factors predicting persistent LUTS medication use after LEP.

Main Methods:

• Retrospective analysis of 864 patients undergoing LEP with 24-month follow-up.
• Assessment of patient-reported use of five LUTS medication classes preoperatively and at 1, 3, 12, and 24 months post-LEP.
• Logistic regression models to identify predictors of persistent medication use.

Main Results:

• LUTS medication use dropped from 84.9% preoperatively to 12.6% at 24 months post-LEP.
• Alpha-blocker and 5-AR-inhibitor use decreased significantly, while PDE-5 inhibitor use increased.
• Preoperative PDE-5 inhibitor use and higher comorbidity (ASA score III/IV) were independent predictors of persistent medication use.

Conclusions:

• LUTS medication use substantially decreases after LEP, with a small percentage of patients requiring continued medication.
• Preoperative PDE-5 inhibitor use and higher comorbidity burden are key predictors of persistent LUTS medication dependence.
• Findings aid in refining preoperative counseling for patients undergoing LEP.