Category: BPH/LUTS: Electrosurgery, Lasers & Other Technology
Introduction & Objective :
Clinical studies have shown that the Prostatic Urethral Lift (PUL) treatment for benign prostatic hyperplasia (BPH) offers rapid, significant and lasting relief of BPH symptoms and improved quality of life. It is not well understood how PUL performs in the “real world” setting and whether outcomes are comparable to those seen in clinical studies.
Data was analyzed from patients treated at a single surgical center from January 2016 through April 2018. 156 men who had symptomatic LUTS with IPSS >= 35 underwent the UroLift® PUL procedure. One patient who was not a candidate for traditional surgery was in retention at time of treatment. Patients had the procedure performed under local (77%) or general (23%) anesthesia and were all treated as outpatient day cases. Between 2 and 5 implants were placed in each patient (average 2.9). IPSS (International Prostate Symptom Score), IPSS quality of life scores (QoL) and peak flow rate (Qmax) were evaluated preoperatively and at 3 months postoperatively. Some patients also contributed 6 month data. These results were compared to the published LIFT data with a student t-test. Length of hospital stay, catheterization rate, and reoperation rate were also captured.
At 3 months, the improvement in IPSS score for the real world patients was 10.0 with sustained effect through 6 months of 10.0 points, similar to the LIFT study results (Table 1). In addition, quality of life improved 2.2 points and peak flow rate improved 4.8 ml/s. These changes are not statistically different from the LIFT trial results. 7.7% of patients required post-operative catheter for average duration 1 day. Average length of hospital stay was 4.5 hours. 7 patients required re-operation with average time to operation of 5 months. 3 patients (1.9%) required transient catheterization for urinary retention (range 7-10 days).
The Prostatic Urethral Lift reduced IPSS, improved QoL, and improved peak flow rate at both the three and six month follow up timepoints for patients in a real world setting. These results are similar to the pivotal LIFT study and indicate that the PUL technique can be applied in the real world safely and effectively.
Mark Rochester– Consultant Urological Surgeon, Norfolk & Norwich University Hospital, Norwich, England, United Kingdom