Continuation of Selective Alpha Blocker After Transurethral Resection of the Prostate Is Associated with a Decreased Risk of Hip Fractures in Elderly Patients Diagnosed with Benign Prostate Hyperplasia

TL;DR

Continuing alpha-blocker medication after prostate surgery may lower hip fracture risk in elderly men, especially those with diabetes.

Contribution

This study shows that long-term alpha-blocker use after TURP reduces hip fracture risk in elderly patients.

Findings

Alpha-blocker users had a 4.2% hip fracture rate versus 5.6% in non-users.

The protective effect was strongest in patients with diabetes.

Continued alpha-blocker therapy was found to be safe regarding hip fracture risk.

Abstract

Hip fractures significantly affect mortality and quality of life in the elderly population. Although alpha-blockers are commonly prescribed for lower urinary tract symptoms after transurethral resection of the prostate (TURP), their long-term safety regarding fracture risk remains controversial. This study aimed to investigate whether long-term alpha-blocker use after TURP affects the risk of hip fractures requiring surgery in elderly men. This study included 6853 male patients aged ≥50 years who underwent TURP between 2000 and 2018. The alpha-blocker group (n = 1371) included patients who continued alpha-blocker treatment after TURP, while the control group (n = 5482) included those who had discontinued the medication. The primary outcome was hip fracture requiring surgical intervention. During follow-up (3.80 ± 1.64 years), hip fracture occurred in 4.2% of the alpha-blocker group versus 5.6% of controls. After adjusting for baseline characteristics and competing risk analysis, alpha-blocker use was associated with a significantly lower risk of hip fracture (p = 0.005). Subgroup analysis revealed particularly strong protective effects in patients with diabetes. Long-term use of alpha-blockers after TURP was associated with reduced hip fracture risk, particularly in patients with diabetes. These findings suggest the safety of continued alpha-blocker therapy after TURP in these patients.

Figures