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

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms Pub Date : 2026-05-01 DOI:10.1111/luts.70062

Maximilian Filzmayer, Miriam I Traumann, Clara Humke, Matthias J Müller, Philipp C Mandel, Luis A Kluth, Andreas Becker, Felix K-H Chun, Marina Kosiba

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引用次数: 0

Abstract

Objectives: To assess rates of medication use for lower urinary tract symptoms (LUTS) over time following laser enucleation of the prostate (LEP) and to identify preoperative predictors of persistent use.

Methods: We retrospectively analyzed 864 LEP patients from an institutional tertiary-care database (11/2017-05/2023) with available 24-month follow-up on medication use. Patient-reported use of five drug classes (alpha-blockers, 5-alpha-reductase (AR)-inhibitors, anticholinergics, beta-3-agonists, and phosphodiesterase (PDE)-5-inhibitors) was recorded preoperatively and at one, three, 12, and 24 months after the procedure. Univariable and multivariable logistic regression models were fitted to identify predictors of persistent LUTS medication use.

Results: Preoperatively, 84.9% of patients used LUTS medication, decreasing to 12.6% within 24 months of follow-up. Alphablocker (80.9%) and 5-AR-inhibitor (13.8%) use declined to 1.8% and 0%, respectively. Anticholinergic (4.6%) and beta-3-agonist (0.3%) use showed a transient postoperative increase with peaks of 10.9% and 1.0% at 3 months, followed by a decline to 2.7% and 0.4% at 24 months, respectively. PDE-5-inhibitor use (1.8%) increased steadily to 5.4% at 24 months. Patient with persistent use exhibited worse baseline QoL and ICIQ-SF scores and higher rates of adiposity, diabetes mellitus, and ASA score III/IV. In multivariable analysis, only preoperative PDE-5-inhibitor use (adjusted OR 3.26, p = 0.002) and ASA score III/IV (adjusted OR 2.08, p = 0.016) remained independently associated with persistent LUTS medication use.

Conclusion: LUTS medication use decreased substantially after LEP, with only a small subset requiring continued medication at 24 months. Preoperative PDE-5-inhibitor use and higher comorbidity burden emerged as independent predictors of persistent LUTS medication use. These findings can refine preoperative counseling regarding postoperative LUTS medication dependence.

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前列腺激光摘除后持续LUTS药物使用的比率和预测因素。

目的：评估激光前列腺摘除（LEP）后下尿路症状（LUTS）的药物使用率，并确定持续使用的术前预测因素。方法：回顾性分析来自机构三级医疗数据库（2017年11月- 2023年5月）的864例LEP患者，并对其用药情况进行24个月的随访。术前及术后1、3、12和24个月记录患者报告的5类药物（α -受体阻滞剂、5- α -还原酶（AR）抑制剂、抗胆碱能药、β -3激动剂和磷酸二酯酶(PDE)-5抑制剂）的使用情况。拟合单变量和多变量logistic回归模型以确定持续LUTS药物使用的预测因素。结果：术前使用LUTS药物的患者占84.9%，随访24个月降至12.6%。Alphablocker（80.9%）和5- ar抑制剂（13.8%）的使用率分别下降至1.8%和0%。抗胆碱能（4.6%）和β -3激动剂（0.3%）的使用显示出术后短暂的增加，在3个月时达到峰值10.9%和1.0%，随后在24个月时分别下降到2.7%和0.4%。pde -5抑制剂的使用（1.8%）在24个月时稳步上升至5.4%。持续使用的患者表现出较差的基线生活质量和ICIQ-SF评分，较高的肥胖、糖尿病和ASA评分III/IV。在多变量分析中，只有术前pde -5抑制剂的使用（调整后的OR为3.26,p = 0.002）和ASA评分III/IV（调整后的OR为2.08,p = 0.016）仍然与持续LUTS药物使用独立相关。结论：LEP后LUTS用药显著减少，只有一小部分患者在24个月时需要继续用药。术前使用pde -5抑制剂和较高的合并症负担成为持续LUTS药物使用的独立预测因素。这些发现可以完善术前对术后LUTS药物依赖的咨询。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

LUTS: Lower Urinary Tract Symptoms UROLOGY & NEPHROLOGY-

CiteScore

3.00

自引率

7.70%

发文量

审稿时长

>12 weeks

期刊介绍： LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided. LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.