Predictors of Medication Cessation After Benign Prostatic Hyperplasia Procedures.

Area of Science:

• Urology
• Surgical Outcomes
• Pharmacology

Background:

• Medication cessation is a key patient goal after benign prostatic hyperplasia (BPH) surgery.
• Limited evidence exists regarding medication cessation rates following BPH surgical interventions.
• Overactive bladder (OAB) medication cessation is also an important consideration.

Purpose of the Study:

• To evaluate medication cessation rates and probabilities for BPH and OAB after surgery.
• To compare cessation outcomes across different BPH surgical procedure types.
• To provide real-world data for patient counseling and shared decision-making.

Main Methods:

• Analysis of Michigan statewide claims data (2017-2022) for patients with pre-existing BPH or OAB medications undergoing BPH surgery.
• Categorization of procedures into transurethral surgery, minimally invasive surgical therapies (MISTs), and simple prostatectomy (SP).
• Definition of medication cessation as no refills between 181 and 365 days postoperatively; multivariable logistic regression used to estimate probabilities.

Main Results:

• Among 12,633 patients, 68% used BPH medications and 7% used OAB medications preoperatively.
• Overall medication cessation rates were 61% for BPH and 62% for OAB.
• Predicted BPH medication cessation probabilities were highest for laser enucleation of the prostate (LEP) and SP (≥84%) and lowest for MISTs (<60%). OAB cessation did not differ significantly by procedure.

Conclusions:

• BPH medication cessation rates significantly vary based on the surgical procedure performed.
• Transurethral surgeries and SP are associated with higher BPH medication cessation.
• MISTs demonstrated lower BPH medication cessation rates, informing surgical choice and patient expectations.