Association between the subsequent benign prostate hyperplasia-related surgery risk and patients treated with Chinese...

The association of Chinese herbal medicines (CHM) with the decreased risk of benign prostatic hyperplasia (BPH)-related surgery in patients with BPH is limited by the small sample size and short follow-up. We try to address this association in a large national sample using 21 years of data.

A random sample composed of two million beneficiaries with newly diagnosed BPH between 2001 and 2016, followed until 2021 in Taiwan's National Health Insurance Research Database was analyzed with a multivariate Cox proportional-hazards model. After 1:1 propensity score matching by baseline comorbidities, age, and the index year, a total of 11,172 patients were assigned to the CHM group (CHM + Western medicine) and 11,172 patients were assigned to the non-CHM group (Western medicine only). The occurrence of BPH-related surgery during the follow-up period was the primary outcome. The Kaplan-Meier method was used to calculate the cumulative incidence of BPH-related surgery in patients with BPH, both those who received CHM treatment and those who did not.

During the study period, 875 CHM users and 870 CHM non-users underwent BPH-related surgery, resulting in surgery incidence rates of 6.89 and 7.26 per 1,000 person-years, respectively. Significantly fewer CHM users than CHM non-users received BPH-related surgery (adjusted HR = 0.89; 95% CI = 0.81, 0.98). A significantly lower risk was observed in those treated with CHM for more than 12 months. Dan Shen and Ji-Sheng-Shen-Qi-Wan were the most commonly prescribed single herb and CHM formula, respectively.

Our study demonstrated that CHM may reduce the long-term risk of BPH-related surgery. Co-treatment with CHM reduced the risk of BPH-related surgery, especially in patients using CHM for over a year.