Prostatic Urethral Lift: A New Minimally Invasive Treatment for Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia

Abstract

Introduction: Prostatic urethral lift (PUL) is a minimally invasive procedure for the treatment of lower urinary tract symptoms (LUTSs) secondary to benign prostatic hyperplasia (BPH). The PUL procedure involves the placement of implants that retract the obstructing prostate lobes. This procedure achieves quantifiable improvements in functional outcomes and quality of life (QoL), while preserving erectile and ejaculatory functions. Methods: Seventeen patients diagnosed with BPH who had undergone the UroLift® procedure between March 2011 and June 2015 were retrospectively evaluated. The parameters evaluated in the pre-operative, intra-operative and 1-year post-operative period were demographic data, and pre-operative, intra-operative and 1-year post-operative results were obtained from the International Prostate Symptom Score (IPSS), Uroflowmetry QoL index, International Index of Erectile Function (IIEF) and Male Sexual Health Questionnaire (MSHQ) for ejaculatory function (MSHQ-EjD). Results: The average improvements from baseline to 12 months after intervention were significant for the total IPSS 9.6. There was a 4.2-point increase in Qmax, a 0.9-point improvement in QoL and a 32% decrease in PVR. No statistically significant difference was found in the IIEF and MSHQ-EjD scores when the pre-operative and post-operative 3rd and 12th month scores were evaluated (p > 0.05). Conclusions: PUL offers rapid improvement in voiding and storage symptoms, QoL and flow rate that is durable to 12 months after intervention. PUL is a minimally invasive procedure that has the moderate effect in treating troublesome LUTS secondary to benign prostatic obstruction and preserving total sexual function.

Urethral Lift as a Safe and Effective Procedure for Prostatic Hyplasia Population: A Systematic Review and Meta-Analysis

“…The above results show that PUL has improved the symptoms of BPH to a certain degree, but still has little difference compared to the former researches. First, PUL can significantly ease the symptoms of LUTS caused by BPH and ameliorate the IPSS to moderate symptoms (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). The average decrease of 11.1 points is similar to the previous study.…”

Update on minimally invasive surgery and benign prostatic hyperplasia

“…There was a 4.2-point increase in Q max , a 0.9-point improvement in QoL and a 32% decrease in postvoid residual urine volume. Sexual function was preserved, with no statistically significant difference ( p > 0.05) in the International Index of Erectile Function (IIEF) and Male Sexual Health Questionnaire for Ejaculatory Dysfunction (MSHQ-EjD) scores [8] .…”

“…Bozkurt et al. [8] reported on 17 patients who underwent treatment with PUL, and reported results out to 12 months. Similar to the results from other studies, PUL was shown to offer rapid improvement in LUTS and QoL and Q max .…”

Analysis of Present Status for Surgery of Benign Prostatic Hyperplasia in Korea Using Nationwide Healthcare System Data

“…It is not yet popular because health insurance has not yet been applied. Although Urolift is currently performed in limited outpatients with high comorbidities due to lack of long-term outcome, it can be applied to more patients since it is an easy and safe procedure with high accessibility and lower incidence of adverse effects [22,23]. It is expected that a significant contribution will be made to one of the alternatives for surgical treatment of BPH.…”