Urethral lift's efficacy, safety sustained at 2 years

In men with BPH, the UroLift System (NeoTract, Inc.) preserves sexual function and provides rapid improvements in symptoms, flow, and quality of life that are sustained to 2 years, new research shows.

A leader in the field of BPH says his group’s experience with the urethral lift has been consistent with the published data, but challenges concerning its widespread use remain.

Results from the 206-patient L.I.F.T. IDE Study, a multicenter, randomized, blinded study, were published in Urology Practice (2015; 2:26–32).

“These results show that the initial benefits of treatment with UroLift, which provides rapid relief of BPH symptoms with minimal side effects, are durable 2 years after treatment, with less than one in ten patients requiring an additional procedure for symptom relief,” said lead author Claus Roehrborn, MD, of UT Southwestern Medical Center in Dallas, and co-principal investigator for the L.I.F.T. clinical program.

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“I look forward to reporting 3-year results of the study in May at the American Urological Association’s annual conference in New Orleans,” Dr. Roehrborn said in a statement from NeoTract.

The analysis from the L.I.F.T. study showed an 88% superiority of urethral lift treatment (140 patients) over sham treatment (66 patients) at 3 months and a sustained therapeutic effect in the UroLift implanted patients at 2 years. The peak urinary flow rate was increased 4.2 mL per second at 3 months and 2 years (p<.0001). By 2 years, 7.5% of patients required an additional procedure for lower urinary tract symptoms.

Adverse events were typically early, mild, and transient. Encrustation did not develop on implants properly placed in the prostate. There was no occurrence of de novo sustained ejaculatory or erectile dysfunction, Dr. Roehrborn and colleagues reported.

Steven A. Kaplan, MD, of Weill Cornell Medical College and the Iris Cantor Men’s Health Center, New York Presbyterian Hospital, New York, has authored an editorial comment about the urethral lift that is in press in European Urology. His comments are primarily directed at an article by Perera et al, a systematic review and meta-analysis of the urethral lift, also in press in European Urology. Symptom improvement with the urethral lift is similar to what has been reported for concomitant therapy with an alpha-blocker and 5-alpha-reductase inhibitor, Dr. Kaplan writes.

Its challenges, he says, relate to pain control when the procedure is performed under local anesthesia and reimbursement in the office setting.

“Our initial experience has been consistent with the published data, yet we do have concerns about its widespread applicability given potential issue with anesthesia and reimbursement,” wrote Dr. Kaplan, a member of the Urology Times Editorial Council. “The UroLift product does require physician education to help with easy insertion and reproducibility. If these challenges are successfully met, PUL [prostatic urethral lift] could be a useful tool in the armamentarium of urologists treating BPH.”

Dr. Roehrborn and four study co-authors disclosed a financial interest and/or other relationship with Neotract.

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