Effect of Sodium-Glucose Cotransporter 2 Inhibitors on International Prostate Symptom Score Following Anatomical Endoscopic Enucleation of the Prostate: A Retrospective Study

Objective: Recently, laser-based anatomical endoscopic enucleation of the prostate (AEEP) has emerged as one of the standard surgical treatments of benign prostate obstruction (BPO). This study investigated the effects of sodium-glucose cotransporter 2 inhibitors (SGLT2i) therapy on lower urinary tract symptoms (LUTS) following AEEP in patients with type 2 diabetes mellitus (T2DM).

Methods: The study included 64 patients with T2DM who underwent AEEP with appropriate preoperative preparation. Patients' clinical, laboratory, uroflowmetry, and ultrasonography findings, along with their International Prostate Symptom Scores (IPSS), were recorded retrospectively both preoperatively and at the first postoperative month.

Results: The mean age of the patients was 66.9 ± 6.4 years, the mean HbA1c level was 6.7 ± 0.9% and 18 (28.1%) patients were receiving SGLT2i. While there were no significant differences between the SGLT2i and non-SGLT2i groups in terms of preoperative pollakiuria, nocturia, urgency, IPSS, prostate-specific antigen (PSA) level, prostate volume, and maximum urine flow rate (Qmax) (P > .05), the post-voiding residual urine volume (PVR) was significantly higher in the SGLT2i group (P=.025). Both groups experienced a significant reduction in IPSS postoperatively compared to the preoperative period (P < .001), with a greater reduction in IPSS observed in the SGLT2i group (P=.031). Postoperative improvements in Qmax and PVR reduction were similar between the groups (P > .05). Multiple linear regression analysis identified SGLT2i therapy, age, and preoperative IPSS level as factors associated with the reduction in IPSS (P < .05).

Conclusion: Despite similar symptoms and clinical findings, patients with BPO using SGLT2i might have a higher preoperative PVR. However, IPSS reduction following AEEP might be greater in patients receiving SGLT2i therapy.

Cite this article as: Barlas IS, Barlas T, Tunc L. Effect of sodium-glucose cotransporter 2 inhibitors on international prostate symptom score following anatomical endoscopic enucleation of the prostate: A retrospective study. Endocrinol Res Pract. 2025;29(4):294-298.