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良性前列腺增生手术治疗后长效下尿路症状药物的使用:一项美国医疗保健索赔分析。

Extended LUTS medication use following BPH surgical treatment: a US healthcare claims analysis.

作者信息

Kaplan Steven, Kaufman Ronald P, Elterman Dean, Chughtai Bilal, Roehrborn Claus

机构信息

Icahn School of Medicine at Mount Sinai, Department of Urology, Mount Sinai, New York, NY, USA.

Albany Medical College, Albany, NY, USA.

出版信息

Prostate Cancer Prostatic Dis. 2025 Feb 27. doi: 10.1038/s41391-025-00953-0.

Abstract

BACKGROUND

Postoperative medication use is an important yet relatively unexplored element of the benign prostatic hyperplasia patient journey. We assessed and compared the percentage of patients who required medication postoperatively after the three most common BPH surgeries in the real world: transurethral resection of the prostate (TURP), photovaporization procedure with GreenLight Laser (PVP), and prostatic urethral lift (PUL) with the UroLift system.

METHODS

Within a random representative sample of US Medicare and commercial insurance claims, patients with at least one year of follow-up data available after an outpatient TURP, PVP, or PUL procedure were linked to pharmaceutical claims to elucidate rates of continuous and de novo use of alpha-blockers, 5-alpha reductase inhibitors, or combination medical therapy. Periods of interest were perioperative (use within three months postoperatively and not beyond) and one and five years postoperatively.

RESULTS

36 629 men diagnosed with BPH underwent outpatient TURP (n = 20 319), GreenLight PVP (n = 10 517) and PUL (n = 5 793) procedures within the claims dataset. The rate of medical therapy use through one year was lowest for PUL (4.1%) compared to TURP (6.2%) and PVP (6.6%), and was equivalent between procedures through five years (10.6% TURP, 10.4% PVP, and 10.3% PUL).

CONCLUSIONS

Patients who undergo surgery to treat BPH may desire to discontinue or bypass BPH medications. However, these data demonstrated that approximately 10% of BPH patients used medication through five years postoperatively, regardless of which procedure they underwent.

摘要

背景

术后药物使用是良性前列腺增生患者就医过程中一个重要但相对未被充分探索的因素。我们评估并比较了在现实世界中三种最常见的良性前列腺增生手术(经尿道前列腺切除术(TURP)、绿激光光汽化术(PVP)以及使用UroLift系统的前列腺尿道悬吊术(PUL))后需要术后药物治疗的患者百分比。

方法

在美国医疗保险和商业保险理赔的随机代表性样本中,将接受门诊TURP、PVP或PUL手术后有至少一年随访数据的患者与药品理赔记录相关联,以阐明α受体阻滞剂、5-α还原酶抑制剂或联合药物治疗的持续使用和重新使用比率。感兴趣的时间段为围手术期(术后三个月内且不超过此期限的使用情况)以及术后一年和五年。

结果

在理赔数据集中,36629名被诊断为良性前列腺增生的男性接受了门诊TURP(n = 20319)、绿激光PVP(n = 10517)和PUL(n = 5793)手术。与TURP(6.2%)和PVP(6.6%)相比,PUL术后一年的药物治疗使用率最低(4.1%),并且在五年内各手术之间的使用率相当(TURP为10.6%,PVP为10.4%,PUL为10.3%)。

结论

接受手术治疗良性前列腺增生的患者可能希望停用或不使用良性前列腺增生药物。然而,这些数据表明,无论接受何种手术,约10%的良性前列腺增生患者在术后五年内仍使用药物。

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