Prostatic Urethral Lift: Does Size Matter?

Shah, Bhavik; Tayon, Kevin; Madiraju, SriGita; Carrión, Rafael; Perito, Paul

doi:10.1089/end.2017.0855

Cited by 21 publications

(12 citation statements)

References 12 publications

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“…In their analysis of outcomes after Greenlight therapy, Pfitzenmaier et al report retreatment rates of 10.4 and 23.1% for patients with prostates < 80 and ≥ 80 cc, respectively [20]. Meanwhile, Shah et al reported retreatment after UroLift was 10% for SP men and 13% for LP men (median time to reintervention: 289 days) [21]. For broader context on retreatment after BPH MISTs, UroLift's original clinical trial had a two-year retreatment rate of 7.5%, while retreatments following prostatic arterial embolization have approached 20% [22,23].…”

Section: Discussionmentioning

confidence: 99%

Rezum therapy for patients with large prostates (≥ 80 g): initial clinical experience and postoperative outcomes

et al. 2021

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Purpose Rezum is a minimally invasive surgery for benign prostatic hyperplasia. Current guidelines recommend Rezum for prostates < 80 cc, but little data exist describing outcomes in patients with prostates ≥ 80 cc. We compare outcomes after Rezum between men with small < 80 cc (SP) and large ≥ 80 cc prostates (LP). Methods Patients undergoing Rezum between Jan 2017-Feb 2020 were subdivided by prostate volume (< 80, ≥ 80 cc). Outcomes were documented pre-and postoperatively. Descriptive analyses of urodynamics data (Qmax, PVR), symptom scores (AUA-SS, SHIM), disease management (medications, catheterization, retreatments), and clinical outcomes were conducted. Results 36 (17.6%) men had prostates ≥ 80 cc (LP mean prostate size 106.8 cc). LP men had improved Qmax and PVR postoperatively; those with longitudinal follow-up exhibited improved Qmax, PVR, and AUA-SS. After one year, alphablocker usage decreased significantly (LP 94.44-61.11%, p = 0.001, SP 73.96-46.15%, p = 0.001); other medication usage and self-catheterization rates remained unchanged. Compared to SP patients, differences in passing trial void (LP 94.44%, SP 93.45%), postoperative UTI (LP 19.44%, SP 10.12%), ED visits (LP 22.22%, SP 17.86%), readmissions (LP 8.33%, SP 4.76%), and retreatment (LP 8.33%, SP 4.76%) were insignificant. However, mean days to foley removal (LP 9, SP 5.71, p = 0.003) and urosepsis rates (LP 5.56%, SP 0.00%, p = 0.002) differed. Conclusion In select LP patients, Rezum provided short-term symptomatic relief and improved voiding function comparable to SP patients. Postoperatively, though alpha-blocker usage decreased significantly, use of other medications did not change, and nearly two-thirds of patients still needed alpha-blockade. Further efforts should explore the possibility of expanding Rezum's inclusion criteria.

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Section: Discussionmentioning

confidence: 99%

Rezum therapy for patients with large prostates (≥ 80 g): initial clinical experience and postoperative outcomes

et al. 2021

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“…A study including 23 patients with prostate volume of >80 g demonstrated significant improvement in AUA symptom score (AUASS) when compared to 51 men with <80 g prostates 61 . However, in this series, 22% of men with prostatic volume of >80 g were found to have a median lobe which required resection or ablation.…”

Section: Minimally Invasive Surgical Treatments (Mist)mentioning

confidence: 75%

Pharmacological and interventional treatment of benign prostatic obstruction: An evidence‐based comparative review

et al. 2021

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“…This study was not conducted in the context of clinical trials, and the real-world BPH included a wide range of patient baseline values. Shah et al [49] evaluated whether the PUL procedure was also effective for larger prostates (prostate size >80 g) and considered that men with larger prostates appear to benefit from PUL. PUL durability in patients with prostate sizes >80 g requires longer follow-up data for assessment and validation.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review and Meta-analysis of Prostatic Urethral Lift for Male Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia

Xiang

Wang

Guan

et al. 2020

European Urology Open Science

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Context Recently, prostatic urethral lift (PUL) is being used to treat lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). Although preliminary clinical studies on PUL are increasing, the long-term efficacy and safety of this procedure are still not well evaluated. Objective The objective of our study is to synthesize the existing literature evidence, and make a comprehensive and long-term systematic review for the PUL procedure. Evidence acquisition A systematic search was performed from the electronic databases including PubMed, Embase, and OVID. The search period was up to January 1, 2020. Comprehensive retrospective and prospective studies on PUL were collected in accordance with specific inclusion and exclusion criteria. Pooled prostatic symptom scores, sexual health scores, and functional outcomes were calculated by using a fixed or random-effect model. Evidence synthesis Nineteen articles meet our determined inclusion and exclusion criteria, and 11 independent patient series were included in the final analysis. Meta-analysis results indicated improvement after the PUL procedure, including International Prostate Symptom Score improvement of 9.73–12.16 points, BPH Impact Index improvement of 3.74–4.50 points, maximum flow rate improvement of 3.44–4.26 ml/s, and quality of life improvement of 2.20–2.55 points. Postvoid residual volume at most of the intervals was not significantly variable. Data regarding sexual function remained stable or improved slightly during the 24-mo follow-up period. Pooled estimates were largely heterogeneous except for sexual function. Conclusions PUL can continue to relieve prostatic symptoms for 24 mo without causing serious complications. The extremely important advantage of the PUL procedure is that it can preserve or slightly improve sexual function. Longer-term and more comprehensive clinical trials are still needed to further clarify the functional outcomes and cost effectiveness of PUL. Patient summary Prostatic urethral lift is an attractive option for selected patients who seek rapid and durable relief of lower urinary tract symptoms with complete preservation of sexual function.

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Prostatic Urethral Lift: Does Size Matter?

Cited by 21 publications

References 12 publications

Rezum therapy for patients with large prostates (≥ 80 g): initial clinical experience and postoperative outcomes

Rezum therapy for patients with large prostates (≥ 80 g): initial clinical experience and postoperative outcomes

Pharmacological and interventional treatment of benign prostatic obstruction: An evidence‐based comparative review

A Systematic Review and Meta-analysis of Prostatic Urethral Lift for Male Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia

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