Real-World Evidence of Prostatic Urethral Lift Confirms Pivotal Clinical Study Results: 2-Year Outcomes of a Retrospective Multicenter Study

Abstract

Introduction: This study expands results from recent prostatic urethral lift (PUL) clinical trials by examining outcomes within a large unconstrained multicenter data set. Methods: Retrospective chart review and analysis of 1413 consecutive patients who received PUL in North America and Australia was performed. International Prostate Symptom Score (IPSS), quality of life (QoL), and maximum urinary flow rate (Qmax) were evaluated at 1, 3, 6, 12, and 24 months post-procedure for all nonurinary retention subjects (Group A) and retention subjects (Group B). Within Group A outcomes were further analyzed using paired t -tests and 95% mean confidence intervals under the following parameters: IPSS baseline ≥13, age, prostate size, site of service, prostate cancer treatment, and diabetic status. Adverse events, surgical interventions, and catheterization rates were summarized in detail. Results: Compared with the randomized controlled prosatic urethral lift (L.I.F.T.) study, subjects in this retrospective study were older and less symptomatic. After PUL, mean IPSS for Group A improved significantly from baseline by at least 8.1 points throughout follow-up. No significant differences were observed between Group A and B follow-up symptom scores. Within Group A, subjects with an IPSS baseline ≥13 behaved similarly to L.I.F.T. subjects. Age, prostate volume, site of service, prior cancer treatment, and diabetic status did not significantly affect PUL outcomes. When completed in a clinic office, PUL resulted in less side effects and catheter placement compared to other sites of service. Previous prostate cancer treatment did not elevate adverse events of high concern such as incontinence and infection. Conclusion: PUL performs well in a real-world setting in terms of symptom relief, morbidity, and patient experience for all studied patient cohorts.

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.…”

Prostatic urethral lift (UroLift): a real-world analysis of outcomes using hospital episodes statistics

“…Our study demonstrates an increase in uptake of the procedure across the NHS during the study period, with 80 NHS trusts providing the procedure in England. In our study 3.7% of patients were aged less than 50 years old, this is higher than the rate reported in a retrospective case review conducted in the US and Australia (17 in 1413, 1.2%) [ 16 ]. However, given the major benefit of PUL is to maintain sexual function there continues to be a strong argument for treating younger men who may wish to preserve normal ejaculation for conception.…”

A state-of-art review on the preservation of sexual function among various minimally invasive surgical treatments for benign prostatic hyperplasia: Impact on erectile and ejaculatory domains

“…Clinical evaluation of the effect of PUL on BPH was also assessed in the same cohort and their 2-year outcomes showed durable improvement in urinary symptoms whilst preserving sexual function [ 60 ]. Positive benefits observed during earlier clinical trials were confirmed in many studies conducted across different countries [ 60 61 62 63 64 65 ].…”