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Open Access 01-07-2019 | Original Article

Minimally invasive prostatic urethral lift (PUL) efficacious in TURP candidates: a multicenter German evaluation after 2 years

Authors: Karl-Dietrich Sievert, Martin Schonthaler, Richard Berges, Patricia Toomey, Desiree Drager, Annika Herlemann, Florian Miller, Ulrich Wetterauer, Bjorn Volkmer, Christian Gratzke, Bastian Amend

Published in: World Journal of Urology | Issue 7/2019

Abstract

Introduction

Successful outcomes have been reported for the treatment of lower urinary tract symptoms (LUTS) with the prostatic urethral lift (PUL) in a number of clinical investigations. Our aim was to investigate PUL outcomes in patients treated in a day-to-day clinical setting without the rigid exclusion criteria of clinical studies.

Materials and methods

We investigated the outcome of the PUL procedure at five German departments during the initial period when PUL was approved for the clinic (10/2012–06/2014). All candidates for transurethral resection of the prostate (TURP) received PUL information and were given the choice of procedures. The only exclusion criterion was an obstructive median lobe. No patients were excluded because of high post-void residual volume (PVR), prostate size, retention history or LUTS oral therapy. Maximum urinary flow (Qmax), PVR, International Prostate Symptom Score (IPSS) and Quality of Life (QOL) were assessed at baseline, 1, 6, 12, and 24 months after surgery.

Results

Of 212 TURP candidates, 86 choose PUL. A mean of 3.8 (2–7) UroLift implants were implanted in patients of 38–85 years with a prostate size of 17–111 ml over 57 (42–90) min under general or local anesthesia. Thirty-eight (38.4%) patients had severe BPH obstruction and would have been denied PUL utilizing previously reported study criteria. Within 1 month 74 (86%) reported substantial symptom relief with significant improvements in Qmax, PVR, IPSS, and QOL (p < 0.001) that was maintained within the follow-up. Sexual function including ejaculation was unchanged or improved. No Clavien–Dindo Grad ≥ 2 was reported postoperatively. Eleven (12.8%) patients were retreated over 2 years. Twelve (86%) of 14 patients presenting with chronic urinary retention were catheter free at last follow-up.

Conclusion

PUL is a promising surgical technique that may alleviate LUTS, even in patients with severe obstruction.

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Title: Minimally invasive prostatic urethral lift (PUL) efficacious in TURP candidates: a multicenter German evaluation after 2 years
Authors: Karl-Dietrich Sievert
Martin Schonthaler
Richard Berges
Patricia Toomey
Desiree Drager
Annika Herlemann
Florian Miller
Ulrich Wetterauer
Bjorn Volkmer
Christian Gratzke
Bastian Amend
Publication date: 01-07-2019
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 7/2019
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-018-2494-1

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Minimally invasive prostatic urethral lift (PUL) efficacious in TURP candidates: a multicenter German evaluation after 2 years

Abstract

Introduction

Materials and methods

Results

Conclusion

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Abstract

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