Increasingly, patients are using sodium-glucose cotransporter-2 inhibitors (SGLT2-i) to manage a number of conditions. The medications are known to impart risks to urologic patients, but their impact on healthcare utilization is unknown. 
This study assessed the impact of SGLT2-I use on 90-day post-operative healthcare utilization following Benign Prostatic Hyperplasia (BPH) procedures.

Utilizing a multi-state integrated health system, a review of 16,050 patients who underwent BPH procedures was completed. Non-parametric Wilcoxon Rank-Sum tests compared median 90-day counts of outpatient encounters stratified by BPH procedure type and SLGT2-i use. Multivariable logistic regression assessed the association between SGLT2-i use and 90-day hospitalization with
adjustment for patient age and BPH procedure type (TURP as reference).

SGLT2-i users had significantly more outpatient encounters within the 90-day postoperative period
for most BPH procedure types, including TURP (p=0.0004), HoLEP (p<0.001), PVP (p=0.0001), Aquablation (p=0.0085), Robotic Simple Prostatectomy (p=0.0008), and PAE (p=0.001). 
Following Aquablation, SGLT2-I use was associated with significantly more of Nurse Visits (p=0.011) and
Distance Health (p=0.0004) encounters.

After adjusting for age and procedure type, SGLT2-i use was independently associated with a 53.3% increased odds of 90-day hospitalization (Adjusted Odds Ratio: OR 1.533, 95% CI 1.348-1.744). While increasing age was also a significant predictor (AOR: 1.028 per year of age, 95% CI 1.023-1.032).

These findings demonstrate that SGLT2 inhibitor use is an independent and potent predictor of increased healthcare utilization following BPH surgery, manifesting as both a higher volume of outpatient encounters and a 53.3% increase in the odds of 90-day hospitalization. This association remains robust across various surgical modalities—ranging from TURP to robotic simple prostatectomy—and notably exceeds the relative risk contributed by advancing age alone. The increased reliance on nurse visits and telehealth, particularly following Aquablation, suggests a higher incidence of postoperative morbidity that requires frequent clinical triage. Consequently, these results highlight a critical need for standardized perioperative protocols and heightened vigilance for SGLT2-i users to mitigate metabolic or infectious complications during the vulnerable 90-day recovery period.

Beyond the negative effects SLGT2-i have on urologic patients, use of SGLT2-i medications independently increases the risk of postoperative hospitalization within 90-days of BPH procedures, as well as the rate of outpatient encounters over the same period. This increased healthcare utilization highlights the burden such medications can place upon patients and the health system.
Mitigation strategies to address require study and may include enhanced perioperative risk assessment and targeted post-operative management.

Continence 19S (2026) 102717
DOI: 10.1016/j.cont.2026.102717