Contemporary Trends of Benign Prostatic Hyperplasia Procedures in the AUA Quality Registry: Are We Moving the Needle Toward More Minimally Invasive Treatments?

Introduction: We sought to determine the utilization of various benign prostatic hyperplasia (BPH) procedures among patients diagnosed with BPH in the US to better understand the dispersion of the various BPH technologies.

Methods: The AUA Quality (AQUA) registry was used to identify patients with a diagnosis of BPH from January 2014 to December 2021. Patient characteristics and procedure characteristics were abstracted. Trends were analyzed using Mann-Kendall tests, and a 2-way analysis of variance test was used to compare treatment utilization.

Results: Of 2,202,107 men diagnosed with BPH in our cohort, 53% (1,173,366) were managed with at least 1 BPH medication, and 7.8% (172,681) received a BPH treatment. Compared to 2014, prostatic urethral lift (n = 178), water vapor thermal therapy (n = 1116), and other genitourinary procedures (n = 254) increased by 3730%, 123%, and 853%, respectively. Regional and racial variations existed based on treatment type. There was significant regional variation in time to intervention based on the state and age of the patient.

Conclusions: The management of BPH has undergone temporal changes throughout the study period. The treatment modalities for BPH vary by region and race in a real-world context.