Back to 2025 Abstracts
National Analysis of Post-Procedural Urinary Incontinence Following Benign Prostatic Hyperplasia Treatments Using a Live Claims Database
Benjamin E. Rubin, BS
1,
Jacob I. Bleau, BS1, Davis C. Moore, MD
2, Curtis A. Plante, BS
1, Sarah Kohl, BS
1, Angelina Kuzina, BS
1, Nicholas Khoo, BS
1, Brian Irwin, MD
2, Mohammad Mohaghegh, MD
2, Richard T. Grunert, MD
2.
1University of Vermont Larner College of Medicine, Burlington, VT, USA,
2University of Vermont Medical Center, Burlington, VT, USA.
Introduction:Benign prostatic hyperplasia (BPH) procedures are commonly performed to alleviate lower urinary tract symptoms, but post-procedural urinary incontinence remains a potential complication. This study evaluates the rates of secondary continence procedures following various BPH interventions, comparing them against the gold standard, transurethral resection of the prostate (TURP).
Methods:This observational study utilized the TriNetX national claims database to identify adult males (≥18 years) who underwent a primary BPH procedure followed by a secondary continence procedure. Patients were identified using CPT codes for BPH interventions, including TURP, holmium laser enucleation (HoLEP), GreenLight laser vaporization (PVP), UroLift, robotic waterjet therapy (RWT), and simple prostatectomies (open retropubic, open perineal, and robotic-assisted simple prostatectomy). We calculated the rates of secondary continence procedures following each intervention. Odds ratios were used to compare the likelihood of reoperation, with TURP serving as the reference.
Results:Among 102,377 men undergoing BPH procedures, only 256 required a secondary continence procedure (0.003%), reflecting the overall low rate of post-procedural incontinence interventions. Rates varied by procedure type (Table 1). The study may be underpowered for certain procedure groups with smaller sample sizes.
Conclusion:The need for secondary continence procedures following BPH surgery occurs at a frequency of approximately 0.21 in 1,000 to 67.4 in 1,000 cases across different BPH surgeries. This study highlights the overall low incidence of surgical interventions for post-procedural incontinence and underscores the importance of non-surgical management options, as these rates do not account for patients with mild incontinence managed non-surgically. Larger studies may further clarify differences among specific procedures.
Table 1. Rates of Secondary Incontinence Procedures Following BPH Interventions
| | | | | | | | | |
| | | n of Cohort | | % Reoperation | | Odds Ratio (95% CI) | | P-value |
| TURP | | 51006 | | 0.002% | | n/a* | | n/a* |
| Open Retropubic SP | | 465 | | 0.004% | | 1.8 (0.5 – 7.4) | | 0.3897 |
| Open Perineal SP | | 89 | | 0.07% | | 30.7 (13.1 – 71.6) | | < 0.0001 |
| Robotic assisted SP | | 1724 | | 0.0006% | | 0.3 (0.03 – 1.7) | | 0.1303 |
| HoLEP | | 14435 | | 0.004% | | 1.9 (1.4 – 2.6) | | < 0.0001 |
| PVP | | 24323 | | 0.003% | | 1.1 (0.8 – 1.5) | | 0.4689 |
| UroLift | | 6652 | | 0.001% | | 0.6 (0.3 – 1.1) | | 0.1046 |
| RWT | | 4683 | | 0.0002% | | 0.09 (0.01 – 0.65) | | 0.0026 |
Odds Ratio calculated as odds of reoperation compared to TURP.
Back to 2025 Abstracts
