Expanding the urethral lumen by mechanically separating the encroaching prostatic lobes is a safe and simple means of providing rapid relief from lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH).
In a pilot study sponsored by NeoTract, manufacturers of The UroLift® System, Henry Woo and colleagues successfully performed a 'prostatic urethral lift' on 19 men with moderate-to-severe LUTS.
The handheld UroLift® device is advanced transurethrally under cystoscopic guidance and used to compress a lateral lobe in an anterolateral orientation. Deployment of a spring-loaded mechanism then anchors polyester suture material via endpieces at two sites: the prostatic capsule and the urethral wall.
An increase in urethral diameter was visually confirmed immediately following placement of between two and five sutures. Cystoscopic follow-up of 12 men about 6 months after the procedure confirmed maintenance of an open urethral lumen, without infection or encrustation of the implanted nitinol/stainless steel endpieces.
Symptomatic improvements were noted as soon as 2 weeks after the prostatic lift. The initial 37% reduction in mean International Prostate Symptom Score persisted at 12 months; quality of life was also notably improved at both time points.
No serious adverse events were reported, and normal sexual function was preserved. Mild and short-lived effects included hematuria, dysuria and irritation. Three patients underwent TURP during the 1-year follow-up period.
While acknowledging the need for a large intention-to-treat study, the authors assert that the lift procedure offers superior symptomatic relief to medical therapy and a better patient experience than other minimally-invasive surgeries.
ORIGINAL RESEARCH PAPER
Woo, H. H. et al. Safety and feasibility of the prostatic urethral lift: a novel, minimally invasive treatment for lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). BJU Int. doi:10.1111/j.1464-410X.2011.10342.x
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Farley, S. Lift and separate to relieve LUTS. Nat Rev Urol 8, 352 (2011). https://doi.org/10.1038/nrurol.2011.88
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DOI: https://doi.org/10.1038/nrurol.2011.88