Four real-world insights reshaping urology: New evidence from Boston Scientific

by Truveta staff | Apr 7, 2026

Four studies using Truveta Data examined real-world outcomes across diverse urology populations, spanning medical therapy, stone disease, oncology, and men’s health.
The analyses identified differences in treatment patterns, safety, and outcomes not captured in traditional clinical trial settings.
Findings include higher ureteral stricture risk with thulium fiber laser, lower prostate cancer recurrence with rectal spacers, and shifts in medication use following finasteride and penile prosthesis implantation.
Together, the studies show how real-world data can expand how urology outcomes are measured in routine clinical practice.

Innovation in urology has historically been measured by procedural success including stone clearance rates, device durability, and short-term safety. These benchmarks matter, but they don’t capture what happens once technologies enter everyday practice across thousands of patients, health systems, and clinical contexts. The most consequential outcomes unfold over months or years.

In four recent publications from Boston Scientific, researchers leveraged large-scale electronic health record (EHR) data from Truveta to explore modern urology outcomes in routine clinical practice across diverse patient populations. Together, these studies highlight how real-world evidence can answer important questions across the urologic spectrum—from medical therapy and stone disease to prostate cancer and men’s health—and demonstrate how longitudinal data is expanding how outcomes are defined and measured in modern urology.

1. Does low-dose finasteride for hair loss have long-term urologic effects?

Finasteride 1 mg is widely prescribed for androgenic alopecia, but its long-term urologic effects remain incompletely understood. While the 5 mg formulation is well studied in benign prostatic hyperplasia (BPH), far less is known about how chronic exposure to the lower dose may influence downstream urologic outcomes.

In a matched-cohort analysis published in The Journal of Urology, Boston Scientific researchers compared 3,470 men taking long-term finasteride 1 mg with an equal number of matched controls. The study evaluated diagnosis rates, treatment patterns, and time to intervention across several urologic conditions.

Men using finasteride were more likely to receive erectile dysfunction medications (PDE5 inhibitors) and to receive them earlier than non-users. At the same time, they had lower rates of elevated prostate-specific antigen (PSA) diagnoses and prostate cancer diagnoses. Rates of benign prostatic hyperplasia (BPH) diagnosis and treatment were similar between groups.

These findings suggest that long-term finasteride use may influence sexual function treatment patterns and PSA-related detection signals without altering BPH outcomes.

2. Does thulium fiber laser lithotripsy change ureteral stricture risk?

Laser technology for ureteroscopic stone treatment continues to evolve, with thulium fiber laser (TFL) systems increasingly used alongside traditional holmium lasers. However, real-world evidence on complication rates for newer laser platforms remains limited. A study published in The Journal of Urology compared outcomes following ureteroscopic laser lithotripsy with thulium fiber versus holmium lasers across 6,726 patients.

Overall complication rates were low, but ureteral strictures occurred more frequently among patients treated with thulium fiber laser (4.6%) compared with holmium laser (2.4%). After adjusting for clinical factors, thulium fiber laser use remained associated with nearly double the risk of stricture formation within 120 days of the procedure.

These findings illustrate how large-scale real-world data can help identify potential safety signals associated with emerging technologies as they move into broader clinical use.

3. Can rectal hydrogel spacing influence prostate cancer control?

Rectal hydrogel spacers are used during prostate radiotherapy to reduce rectal toxicity and improve quality of life. However, their potential impact on oncologic outcomes has been less clear.

In a study published in International Journal of Radiation Oncology, Biology, Physics, researchers analyzed 36,866 patients undergoing primary external beam radiation therapy for prostate cancer. Patients who received rectal hydrogel spacers were compared with matched controls who underwent radiation therapy without spacing.

Patients who received rectal spacers demonstrated lower rates of biochemical recurrence following treatment (5%) compared with matched controls (11.4%). After adjustment for clinical factors, spacer placement remained associated with lower odds of recurrence.

These findings suggest that technologies introduced to reduce treatment toxicity may also influence longer-term oncologic outcomes, warranting further investigation.

4. Does penile prosthesis implantation influence mental health treatment patterns?

Erectile dysfunction is closely linked to depression and anxiety, but the broader psychological impact of surgical treatment has been difficult to measure at scale.

In a study published in The Journal of Sexual Medicine, researchers used real-world EHR data to examine medication use among men undergoing penile prosthesis implantation. The analysis included 597 patients who had been prescribed antidepressant or anti-anxiety medications in the year prior to surgery.

Within one year after implantation, 39% of these patients discontinued their depression or anxiety medications. These findings suggest that successful treatment of erectile dysfunction may influence broader patient well-being, including mental health treatment patterns observed in routine care.