Urocross shows sustained benefit through 24 months post-removal

A temporary prostatic urethral implant designed for intentional retrieval at 6 months produced sustained and deepening voiding symptom improvement through 24 months post-retrieval—findings that Kevin T. McVary, MD, FACS, interpreted as physiologic evidence that structural remodeling of the prostatic urethra is real, durable, and clinically meaningful.¹

The benign prostatic hyperplasia device known as the Urocross Expander System, evaluated in the Expander-2 randomized controlled trial, applies gradual axial pressure to the prostatic outlet while indwelling, then is retrieved at 6 months—leaving no permanent foreign body. Among 160 men in the active treatment arm, International Prostate Symptom Score (IPSS) scores improved 32% at 6 months while the device was in place, then continued to deepen after retrieval: 45.2% at 1 month post-retrieval, 49% at 6 months post-retrieval, and 56.8% at 24 months post-retrieval. Quality of life scores improved from 4.6 to 2.2—a 48.7% gain—and Qmax increased from 8.8 mL/s to 12.5 mL/s. Treatment response, defined as at least 30% IPSS improvement, was achieved by 74.4% of patients at 12 months. Extended catheterization rates were low (0.6% post-implant; 2.5% post-retrieval), and no device- or procedure-related serious adverse events occurred.

"The fact that you see sustained effects 2 years after retrieval tells you it's not transient. It's biologic—physiologic—evidence that the remodeling has actually occurred and is of benefit,” McVary said.

McVary described what he called a "symptomatic boost" that occurs after retrieval—the acceleration of improvement observed once the device is removed. His mechanistic interpretation: By 6 months, prostatic remodeling is largely complete, and removing the implant eliminates whatever residual contribution the foreign body itself may have had to lower urinary tract symptoms.

"The device is out—that's one less thing to impede flow," he said. The sustained flow improvement following retrieval, he argued, is difficult to explain without accepting that structural change in the prostatic outlet has occurred.

A distinctive feature of the Urocross approach is what McVary characterized as the preservation of future treatment options. Because the device is fully retrieved, no permanent implant occludes the prostatic urethra. Should symptoms recur years later, the full range of BPH interventions remains available—including, hypothetically, another cycle of Urocross implantation.

"You could reinitiate a whole other round of remodeling. Because it's being retrieved, you're really not closing the door on anything,” McVary said.

The retrieval procedure itself has been systematically characterized—an analysis McVary noted is the first to formally quantify what device retrieval requires in this context. Performed in-office in a few minutes, retrieval was well tolerated with minimal reported pain.

"Patients are totally ambulatory. Pretty simple in office, a few minutes, well tolerated—very mild, very modest pain at retrieval."

REFERENCE

1. McVary KT, Rukstalis D, The Expander-2 Investigators. Presented at: 2026 American Urological Association Annual Meeting; May 15-18, 2026; Washington DC. doi:10.1097/01.JU.0001192572.07890.f8.12