Madrid, Spain—A patient follow-up report shows promising mid-term results from five German urology centers that implemented the prostatic urethral lift (UroLift System, NeoTract, Inc.) to alleviate symptomatic BPH in patients suffering from mild, moderate, and even severe obstruction.
The outcomes reflect the benefits of PUL in patients with symptoms normally contraindicated in PUL clinical trials; previous studies included patients with mild to moderate obstruction only and no complications.
The prostatic urethral lift (PUL) uses anchors that are placed in the prostate and on the inside of the urethra, which through gentle pulling action create a channel in the urethra that allows the patient to void. The advantage of the procedure over transurethral resection of the prostate lies in the absence of tissue ablation, eliminating the dreaded complication of retrograde ejaculation and preserving patients’ sexual function, researchers say.
No retrograde ejaculation with technique
“Men want to preserve their sexual activity, and one of the major complications of TURP, unfortunately, is retrograde ejaculation. Using UroLift, we matched the results seen in PUL clinical trials and did not see this complication. Thirty-seven percent of our more severely obstructed patients would have been denied PUL, since clinical trials exclude patients with prostates larger than 40 mL to 50 mL. We also included patients with retention, another trial contraindication,” said senior author Karl-Dietrich Sievert, MD, PhD, chair of urology at the University of Lübeck, Lübeck, Germany.
Dr. Sievert reported on the outcomes of 70 patients (age 38-85 years) from five German centers who underwent PUL instead of TURP following patient education. The prostate volume (PV) ranged from 17 mL to 111 mL (mean PV: 43±18.8 mL) and seven patients had a high post-void residual (PVR) of 250 mL or greater. He followed the patients for 0.5 to 18 months (mean follow-up, 9.05± 5.55 months) and evaluated them prior to and after surgery using maximum flow rate (Qmax), PVR, International Prostate Symptom Score, and quality of life.