iTind preserves ejaculatory and erectile function in patients with BPH

In a study presented at the 2021 AUA annual meeting, Bilal Chughtai, MD, and co-authors implemented the new iTind system, designed to treat patients with LUTS secondary to BPH by implanting the device via a cystoscopic procedure.

In patients with lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH), one of the main concerns is preserving their ejaculatory and erectile function post-treatment. In recent years, many researchers are innovating new treatments and therapies that prioritize that preservation.

In a study presented at the 2021 American Urological Association Annual Meeting,1 Bilal Chughtai, MD, and his team of investigators implemented the new iTind system, designed to treat patients with LUTS secondary to BPH by implanting the device via a cystoscopic procedure. Chughtai is an associate professor of urology, obstetrics and gynecology at Weill Cornell Medicine and an attending urologist at New York-Presbyterian Hospital, New York City, New York.

Please provide an overview of the iTind system and its use in treating LUTS secondary to BPH.

The iTind system is a novel system that is FDA-approved for treating enlarged prostate. Essentially, the way the iTind system works is that there is a device that is placed within the prosthetic urethra and incises the prosthetic urethra at the 12, 5 and 7 o'clock positions. These incising struts reshape the urethra over the course of 5 to 7 days, and then the whole device is removed. What's novel about the iTind system is that it's one of the first treatments that can be deployed through a flexible cystoscope, as well as the fact that there is no heat energy used or permanent foreign body that's left within the prosthetic urethra.

What are the advantages of iTind compared with other treatments for BPH?

When it comes to iTind, the biggest advantages are that it can be done completely in the office and through a flexible cystoscope with local anesthetic. Also, it doesn't have a permanent foreign body. The iTind device is removed after approximately 5 to 7 days, and there's no energy that's delivered to the prosatic tissue. Therefore, that translates to improvement in lower urinary tract symptoms secondary to enlarged prostate, and at the same time it doesn't change erectile function or ejaculatory function after the procedure.

What are some of the notable findings from this study, and were any of them surprising to you and your co-authors?

This was an analysis from the multicenter iTind study, and it really focused on sexual function and ejaculatory function. What we found was that there was no change across all groups in terms of sexual function or ejaculatory function. What was notable, though, was that in younger sexually active men, there is known to be an increase in erectile function post-procedure. Although this is not a statistically significant finding, it does show the fact that there's complete preservation of erectile function and ejaculatory function in this cohort.

What is the take-home message for the practicing urologist?

For the practicing urologist, I think iTind really adds to the armamentarium of procedures that are available for BPH that preserve ejaculatory and sexual function. So, it's something for urologists who are looking for office-based procedures to incorporate that can help their practice.

Is further research on this topic planned? If so, what will the focus be?

My understanding is that the company does have further trials that they're looking at. At this point, we are offering iTindat my practice and are collecting data to see what the results look like longer term and generate real-world evidence for it.

Is there anything else you feel our audience should know about this research?

Ultimately, the iTind system is novel and new. I think the data is out to about 3 years now, so the data is a little bit on the immature side, but it's very promising. I think the fact that this is one of the first treatments that doesn't leave a permanent foreign body, and the fact that there's no energy delivered shows a lot of promise and has a lot of interest from the patient standpoint.

Reference

1. Chughtai B, Kaminetsky J, Shore N. Preservation of ejaculatory and erectile function with iTind system for treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia. Paper presented at 2021 American Urological Association Annual Meeting. September 10-13, 2021; virtual. Abstract MP01-06