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Prostatic Urethral Lift for LUTS Secondary to BPH: Prospective Real World Experience
Andrew L Hirsh Jersey Urology Group, Somers Point, NJ
Introduction: The Prostatic Urethral Lift (PUL) is a minimally invasive treatment for symptomatic benign prostatic hyperplasia (BPH). We report a prospective study in a US Urology practice. Materials and Methods: Between July 2014 and February 2015, 53 subjects were enrolled and treated with PUL. Follow up at one month or later included adverse event rate, AUASI (American Urological Association Symptom Index), QOL (Quality of Life), and Qmax (peak urinary flow rate). Results: There were no significant complications. An average of 4.9 implants [range 2-8] were used to treat prostates ranging from 25 to 108 cc (mean 49.3 cc). Adverse events were mild and transient (dysuria and hematuria). No patient reported loss of ejaculatory or erectile function. Prior to PUL, 4 subjects had at one point undergone BPH treatment (2 TURP, 2 microwave), and one patient had undergone prior radiation for prostate cancer. AUASI, QOL, and Qmax all improved significantly, both clinically and statistically. Symptom improvements were in line with randomized controlled study reports; peak urinary flow improvement was higher (8mL/sec). Conclusion: PUL performs in every day practice in a similar fashion to published controlled studies. Symptoms, flow and quality of life improve significantly, while adverse effects are mild and transient. PUL presents a valuable new treatment for LUTS that offers rapid relief while preserving sexual function.
Table 1: Baseline, follow-up, and change in each paired outcome measure after PUL treatment. | AUA-SI | QOL | Qmax | n | 30 | 25 | 21 | Baseline | 19.03 ± 5.29 | 4.32 ± 1.14 | 9.21 ± 4.64 | Follow-up | 11.10 ± 5.96 | 2.32 ± 1.35 | 17.08 ± 5.86 | Change | -7.93 ± 8.28 | -2.00 ± 1.39 | 7.87 ± 6.38 | % Change | -36.9% ± 36.8% | -46.9% ± 25.9% | 119.4% ± 139.1% | p-value | <0.0001 | <0.0001 | <0.0001 |
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