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  • Review Article
  • Published:

New intraprostatic injectables and prostatic urethral lift for male LUTS

Nature Reviews Urology volume 12, pages 461–471 (2015)Cite this article

Subjects

Key Points

  • Minimally invasive treatments have been developed to offer rapid and effective relief of lower urinary tract symptoms (LUTS) with less perioperative and postoperative morbidity than is associated with ablative procedures

  • Although experimental evidence for new intraprostatic injectables such as NX-1207, PRX302 and botulinum neurotoxin A was promising, randomized, controlled trials failed to demonstrate their clinical efficacy

  • With the development of new medical devices, such as the prostatic urethral lift, the rapid and durable relief of LUTS seems possible, without compromising sexual function

  • Further clinical trials are needed to define the role of novel minimally invasive treatment options between pharmacotherapy and surgical procedures in the management of male LUTS

Abstract

Treatment modalities for male lower urinary tract symptoms (LUTS) comprise a broad spectrum of medical and surgical options. Interest is growing in minimally invasive treatment options, which should ideally be performed in an outpatient setting and have a short recovery time, durable efficacy and a good safety profile. The preservation of all aspects of sexual function, including antegrade ejaculation, seems to be increasingly important for patients. Initial experimental data on new minimally invasive procedures—such as the intraprostatic injection of novel agents including botulinum neurotoxin A (BoNT-A), NX-1207 and PRX302—were promising, but clinical trials have not confirmed the findings. Trials of the mechanical prostatic urethral lift device—Urolift® (Neotract, Inc., USA)—have been positive, but further long-term results are needed to confirm its beneficial effects.

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Figure 1: The pathophysiology of lower urinary tract symptoms caused by benign prostatic obstruction and approaches to modulate it by intraprostatic injection.
Figure 2: Prostatic urethral lift (Urolift® [Neotract Inc., USA]).

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  1. Urologische Klinik und Poliklinik, Klinikum der Universität München—Campus Grosshadern, Ludwig-Maximilians-Universität München, Marchioninistrasse 15, 81377, Munich, Germany

    Giuseppe Magistro, Christian G. Stief & Christian Gratzke

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G.M. researched data for the article, G.M. and C.G. made substantial contributions to discussions of content and wrote the article and all authors reviewed and edited the manuscript before submission.

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Correspondence to Christian Gratzke.

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Magistro, G., Stief, C. & Gratzke, C. New intraprostatic injectables and prostatic urethral lift for male LUTS. Nat Rev Urol 12, 461–471 (2015). https://doi.org/10.1038/nrurol.2015.169

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