NorthPoint Domain

Urology: Prostatic Urethral Lift Safe and Feasible BPH Treatment

The procedure was successful in all patients with no implant-related adverse events

A small study published recently in BJU International found that a minimally invasive procedure was safe and feasible for patients with symptomatic benign prostatic hyperplasia (BPH). The study authors write that most patients reported sustained symptom relief to 12 months.

In the prostatic urethral lift (PUL) procedure, the lateral lobes of the prostate are displaced toward the capsule to expand the urethral lumen. Small suture-based implants are then positioned to secure the lobes and maintain the expanded urethra. Work with canines and cadavers led the authors of the current study to believe that PUL relieves symptoms with low morbidity and a better patient experience.

The authors thus performed the procedure on 19 men (aged 55 years and older) with moderate-to-severe symptomatic BPH between 2005 and 2007. Follow-up assessments occurred at two weeks and three, six, and 12 months post-procedure to document adverse events (AEs), serum prostate-specific antigen and creatinine levels, uroflowmetry, and TRUS. Some patients also underwent cystoscopy at six months. Surgery was successfully completed in all 19 patients without procedure or implant-related AEs. The most common AEs were hematuria, dysuria, and irritative symptoms. As early as two weeks post procedure, there was a mean reduction of 37 percent in the International Prostate Symptom Score and a 40 percent mean reduction in quality of life score (reduction indicates improvement), which continued throughout the study period.

The authors conclude that, “These initial results suggest that PUL has the potential to deliver rapid symptom relief with minimal short- and long-term morbidity and a low incidence of sexual dysfunction. The PUL could address the clinical need for a minimally invasive BPH treatment that offers a better patient experience than existing thermotherapy approaches while still preserving future therapeutic options. Further study is indicated to evaluate this promising and interesting technique.”

Source: Woo HH, Chin PT, McNicholas TA, et al. 2011. Safety and feasibility of the prostatic urethral lift: a novel, minimally invasive treatment for lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). BJU International 108:82-88.