LUTS medication use after TURP is common but not evidence-based

  • Campbell J & al.
  • Urology
  • 23 May 2019

  • International Clinical Digest
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Takeaway

  • Despite scant clinical evidence, 62% of patients with lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) are treated with prostate-specific alpha blockers (AB), 5-alpha reductase inhibitors (5ARI), or anticholinergics/beta-3 agonists (AC/B3) after transurethral resection of the prostate (TURP).

Why this matters

  • Urologists should follow patients post-TURP to ensure adequate treatment of LUTS and reduce rates of unwarranted medication use.

Study design

  • Researchers analyzed the health records of patients aged >66 years undergoing their first TURP (N=58,038; median age, 75 years; median follow-up, 4.9 years).
  • Primary outcome: ≥30 days of AB, 5ARI, or AC/B3 use after TURP.
  • Funding: St. Joseph's Health Care Foundation.

Key results

  • 6 months before TURP, 49.8% of patients were treated with AB, 31.9% with 5ARI, and 6.0% with AC/B3.
  • 90 days after TURP, 27% of patients were treated with AB, 20% with 5ARI, and 15% with AC/B3.
  • Family physicians prescribed the most AB; urologists prescribed the most AC/B3.

Limitations

  • The study was retrospective.
  • Results may not apply to patients
  • Medication use was based on filled prescriptions.