LAUSR

PURPOSE Our current understanding of recent trends in management of lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS/BPH) is incomplete, particularly for younger men. The 2018 Urological Diseases in America project attempted to fill this gap by analyzing multiple large administrative claims databases that include men of all ages and permit longitudinal follow-up. We report these findings for the first time in the scientific literature. MATERIALS AND METHODS The two data sources used in this study included the Optum© de-identified Clinformatics® Data Mart Database for men 40-64 years of age and the Medicare 5% Sample for men 65+ years of age. To assess trends in LUTS/BPH-related medication prescriptions and surgical procedures from 2004-2013, we created annual cross-sectional cohorts and a longitudinal cohort of incident LUTS/BPH patients with five years of follow-up. RESULTS Use of LUTS/BPH-related medications increased with age, particularly among those aged 40-60 years. While medication usage increased over time, surgical procedures decreased. Increasing age correlated with a higher rate of surgical procedures in the longitudinal cohort. Younger men were more likely to select LUTS/BPH treatments that reportedly optimize sexual function. CONCLUSIONS Medication usage increased and surgery decreased over the study period. Treatment approaches for LUTS/BPH varied greatly by patient age. While the minority of men in their 40s and 50s required treatment, a sharp increase in treatment utilization was seen between these decades. Younger men were more likely to select less invasive surgical options. Future LUTS/BPH studies should focus on age-specific treatment selection.