UroLift in Place of Fiducial Markers for Patients With Benign Prostatic Hyperplasia Undergoing External Beam Radiation Therapy

Keehn, Aryeh; Fram, Ethan; Garg, Madhur; Maria, Pedro

doi:10.1016/j.urology.2016.11.029

Cited by 14 publications

(7 citation statements)

References 23 publications

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“…The volume of resected prostate or the use of either monopolar or bipolar TURP was not associated with an increased risk of sexual dysfunction [31–34, 35•]. With regard to other adverse effects, it is important to note that there is an increased risk of urinary incontinence if a TURP is performed in patients who have undergone brachytherapy for prostate cancer [36, 37].…”

Section: Bph Surgeries and Sexual Dysfunctionmentioning

confidence: 99%

Minimizing Sexual Dysfunction in BPH Surgery

Leong

Patel

Ramasamy

2019

Curr Sex Health Rep

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Purpose of Review To review the prevalence and risks of sexual dysfunction associated with current treatment options for benign prostatic hyperplasia and to characterize techniques and methods to manage postoperative sexual dysfunction-related side effects. Recent Findings Current surgical therapies available for the treatment of benign prostatic hyperplasia are associated with a substantial risk of both ejaculatory and erectile function. However, many of the novel minimally invasive treatment alternatives have demonstrated the ability to preserve postoperative sexual function to a better degree, all while providing significant relief of lower urinary tract symptoms in an equally safe and efficacious manner. Summary Benign prostatic hyperplasia remains a highly prevalent disease among the aging population. While surgical treatments are often necessary to relieve bothersome urinary symptoms, these procedures are associated with an increased risk of sexual dysfunction. As such, there has been an increased interest in the development of minimally invasive therapies, such as the UroLift®, Rezum®, and Aquablation®, with the hopes of achieving similar symptomatic relief while maintaining sexual function. Aside from reporting lower rates of sexual dysfunction, these procedures have also demonstrated comparable safety, durability, and efficacy to current gold standard therapies. Some procedures can even be performed in an outpatient setting, avoiding the need for general anesthesia altogether. Overall, an individualized, shared decision-making approach is necessary to determine the ideal treatment option for each patient.

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Section: Bph Surgeries and Sexual Dysfunctionmentioning

confidence: 99%

Minimizing Sexual Dysfunction in BPH Surgery

Leong

Patel

Ramasamy

2019

Curr Sex Health Rep

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“…3,8 Unfortunately, some patients are contraindicated for surgery and others refuse FM insertion. 3,15 This study's findings suggest that it is feasible to use UroLift implants in lieu of FM insertion for CBCT matching in these patients and for those who have already had a UroLift procedure. There were some slight differences in alignments between CBCTUroLift and CBCTProstate, although these were all less than 3 mm in magnitude.…”

Section: Discussionmentioning

confidence: 81%

“…The implants are situated in prostate tissue and are radio-opaque, so visualisation of these could be a feasible alternative means of confirming treatment position on a daily basis. 15,16 This would eliminate the overall cost and time of an extra procedure for the increasing numbers of patients presenting with the UroLift system in place. 17 Indeed, the prevalence of obstructive dysuria arising in prostate radiotherapy patients has been highlighted as a potential rationale for replacing FM with UroLift.…”

Section: Introductionmentioning

confidence: 99%

“…17 Indeed, the prevalence of obstructive dysuria arising in prostate radiotherapy patients has been highlighted as a potential rationale for replacing FM with UroLift. 15 Both Keehn 15 and Biswal 16 identified how the radio-opaque UroLift implants could be used for orthogonal image matching, yet there is a paucity of research on their use as a FM substitute in CBCT matching, and accordingly this study aimed to evaluate the feasibility of this technique for a single case.…”

Section: Introductionmentioning

confidence: 99%

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UroLift implants as surrogate fiducial markers for cone-beam CT-based prostate image-guided radiotherapy

et al. 2023

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Introduction: UroLift implants are a novel treatment for the obstructive lower urinary tract symptoms arising from benign prostatic hyperplasia. This case study aimed to assess their effectiveness as fiducial marker (FM) surrogates in prostate image-guided radiotherapy (IGRT). Method: Cone-beam CT images from a patient receiving prostate radiation therapy underwent manual alignment using UroLift implants and also prostate soft-tissue matching by five experienced therapeutic radiographers. The match values of both methods were compared using Bland–Altman analysis. All five observers were also asked to score the ease of matching using both approaches. Results: The 95% mean level of agreement for the UroLift matches were within a 2-mm threshold in all dimensions. Comparison of UroLift and prostate matches had 95% limit of agreement values of −0·98 to 1·78, −0·58 to 0·49 and −1·83 to 1·04 mm in the vertical, longitudinal and lateral planes, respectively. All of the UroLift matches were rated as ‘very easy’ or ‘possible with little difficulty’ by the five observers. Conclusion: A small difference between the CBCT UroLift and CBCT prostate match was found. It has been shown that IGRT to the prostate with the aid of the UroLift system implants and CBCT is feasible and can eliminate the need for FM implants. Wider evaluation in a large cohort is recommended.

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“…Klinische Studien zur Beantwortung der Frage, ob die Technik auch in diesen Fällen geeignet ist, ist Gegenstand aktuell laufender Studien (Cli-nicalTrials.gov; Identifier: NCT02625545). Grundsätzlich lassen sich alle ablativen Therapieverfahren nach einem Urolift ohne Einschränkung durchführen [16,17].…”

Section: Introductionunclassified

Neue minimalinvasive Therapieoptionen des benignen Prostatasyndroms

et al. 2018

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The main objective of novel minimally invasive treatment options is to be equally effective to current reference techniques while providing a superior safety profile. Especially the preservation of sexual function, including ejaculatory function, is of great interest to patients facing surgical treatment of lower urinary tract symptoms (LUTS). Ideally, a truly minimally invasive procedure can be performed under local anaesthesia in an outpatient setting. Among emerging medical devices, the prostatic urethral lift (PUL; Urolift) demonstrated rapid and durable relief of LUTS in selected patients without a prominent middle lobe. Compared to the reference method TURP, it was superior in terms of preservation of sexual function and recovery experience. The first clinical evaluation of the "Temporary Implantable Nitinol Device" (TIND) proved its feasibility, efficacy and safety for the treatment of LUTS over a 3-year follow-up period. However, prospective randomised controlled trials are still needed to evaluate its true benefit. New ablative technologies like Rezũm are based on convective water vapour energy and have shown good results in a sham-controlled randomised clinical trial for the treatment of LUTS over a follow-up period of 3 years. Of note, this procedure was also successful in patients with a prominent middle lobe, and no impairment of sexual function was reported after Rezũm. Innovative technologies like Aquablation (AquaBeam) are still in their infancy, but the first clinical outcomes are promising, even in comparison with the reference method TURP.

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UroLift in Place of Fiducial Markers for Patients With Benign Prostatic Hyperplasia Undergoing External Beam Radiation Therapy

Cited by 14 publications

References 23 publications

Minimizing Sexual Dysfunction in BPH Surgery

Minimizing Sexual Dysfunction in BPH Surgery

UroLift implants as surrogate fiducial markers for cone-beam CT-based prostate image-guided radiotherapy

Neue minimalinvasive Therapieoptionen des benignen Prostatasyndroms

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