Prostatic urethral lift for the treatment of lower urinary tract symptoms in men with benign prostatic hyperplasia

Jung, Jae Hung; Reddy, Balaji; McCutcheon, Karen; Borofsky, Michael S.; Narayan, Vikram M.; Kim, Myung Ha; Dahm, Philipp

doi:10.1002/14651858.cd012832.pub2

Cited by 22 publications

(8 citation statements)

References 67 publications

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“…Similarly, a multi-centre German study [ 68 ] reported no change in sexual function postoperatively. The Cochrane review [ 69 ] found that whilst PUL preserved erectile function and is associated with better ejaculatory function, the actual improvement in urinary symptoms was inferior compared to TURP. The MedLift study [ 70 ] which was an extension of the LIFT randomized study found that men with middle lobe prostatic obstruction can be treated with PUL with ≥40% of sexually active men reporting an improvement in erectile function at 12 months review.…”

Section: Resultsmentioning

confidence: 99%

A state-of-art review on the preservation of sexual function among various minimally invasive surgical treatments for benign prostatic hyperplasia: Impact on erectile and ejaculatory domains

Chung

2021

Investig Clin Urol

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There is a strong association between benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) and sexual dysfunction. While transurethral resection of the prostate (TURP) is considered the standard BPH treatment, it is however associated with a high rate of erectile and ejaculatory dysfunctions. Over the past decade, new and novel minimally invasive BPH therapies have been shown to improve various parameters of voiding domains while minimizing adverse sexual effects. These minimally invasive BPH therapies can be largely be divided into those with cavitating technology (Rezum, Histotripsy, Aquablation), intra-prostatic injections (Botulinum neurotoxin Type A, Fexapotide Triflutate, prostate specific antigen-activated protoxin PRX-302), and mechanical devices which include intraprostatic stents (Urospinal 2™, Memotherm™, Memokath™, and Allium triangular prostatic stent™) and intraprostatic devices (iTIND™, Urolift™), as well as prostatic artery embolization. Published literature on these technologies showed reasonable preservation of erectile function with limited data reported on ejaculatory domain. Further validation of the performance of these novel minimally invasive treatment options for LUTS due to BPH in well-designed and multi-centre studies are desired, to evaluate their role (or lack of such a role) in clinical practice and whether these BPH therapies can provide equivalent standard or better than TURP.

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Section: Resultsmentioning

confidence: 99%

A state-of-art review on the preservation of sexual function among various minimally invasive surgical treatments for benign prostatic hyperplasia: Impact on erectile and ejaculatory domains

Chung

2021

Investig Clin Urol

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“…Most previous studies have suggested that PUL can significantly improve the symptoms and quality of life of LUTS (9,10,21,22); only a small number of studies believe that this improvement is not significant compared to TURP (23)(24)(25)(26). The above results show that PUL has improved the symptoms of BPH to a certain degree, but still has little difference compared to the former researches.…”

Section: Discussionmentioning

confidence: 67%

Urethral Lift as a Safe and Effective Procedure for Prostatic Hyplasia Population: A Systematic Review and Meta-Analysis

Jing

et al. 2020

Front. Surg.

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Background: Prostatic urethral lift (PUL) is a relatively new minimally invasive treatment procedure for benign prostatic hyperplasia (BPH). In order to analyze the sustainability of this new protocol, a systematic review and meta-analysis is performed based on the published articles.Methods: We performed a critical review according to the preferred reporting items for systematic review and meta-analysis (PRISMA) and MOOSE guidelines. A total of 818 published articles matched our search terms, and 11 studies met the inclusion criteria. Data of each follow-up time point (1, 3, 6, 12, and 24 months) were analyzed in terms of baseline characteristics and functional and sexual health outcomes. The merged means of each time point were calculated using R package meta and shown in the tendency plot.Results: A total of 1,443 patients who underwent PUL are available for the research. At 24 months, the changes of the three indicators are statistically significant (IPSS 9.40 points, p < 0.001; Qmax 3.39 ml/s, p < 0.001; QoL 1.99 points, p < 0.001) but were not as effective as TURP (from literature). The trend plot shows that, as time goes on, the effect of PUL tends to increase first and then weaken. Three items fitted a meaningful curve: IPSS (slope = −1.378 t = −12.395, p < 0.001), Qmax (slope = −1.382 t = −6.429, p < 0.001), and QoL (slope = −0.218, t = −10.058, p < 0.001). Fitted curves of SHIM and PVR are not statistically significant. The regression reveals that IPSS, Qmax, and QoL could be predicted after accepting PUL.Conclusion: PUL appears to be a safe and effective procedure in selected patients with BPH and can improve the symptoms of urinary tract obstruction. However, it is not as effective as TURP and shows no influence to the objective indicators like PVR.

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“…Some alternatives to TURP include laser enucleation, vaporisation, and Aquablation, but they all require spinal anaesthesia [ 2 ]. In recent years, the number of men undergoing TURP has steadily declined due to increasing pharmacologic treatments (alpha-blockers and 5-alpha-reductase inhibitors) and minimally-invasive treatments that are usually performed under local anaesthesia [ 6 ], such as convective radiofrequency water vapour therapy [ 7 ], prostatic urethral lift [ 8 ], prostatic arterial embolisation [ 9 ] which are covered in current evidence-based guidelines [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Transurethral Microwave Thermotherapy for Benign Prostatic Hyperplasia: An Updated Cochrane Review

Franco

Garegnani

Liquitay

et al. 2022

World J Mens Health

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Purpose To assess the effects of transurethral microwave thermotherapy (TUMT) for the treatment of lower urinary tract symptoms in men with benign prostatic hyperplasia (BPH). Materials and Methods We performed a comprehensive search using multiple databases up to May 2021, with no language or publication status restrictions. We included parallel-group randomized controlled trials of participants with BPH who underwent TUMT. We used standard Cochrane methods, including a GRADE assessment of the certainty of the evidence (CoE). Results In this update of a previous Cochrane review, we included 16 trials with 1,919 participants. TUMT probably results in little to no difference in urologic symptom scores at short-term follow-up compared to transurethral resection of the prostate (TURP). There is likely to be little to no difference in the quality of life. TUMT likely results in fewer major adverse events. TUMT, however, probably results in a large increase in the need for retreatment. There may be little to no difference in erectile function between these interventions. However, TUMT may result in fewer cases of ejaculatory dysfunction compared to TURP. The overall CoE was moderate to low. Conclusions TUMT provides a similar reduction in urinary symptoms compared to TURP, with fewer major adverse events and fewer cases of ejaculatory dysfunction at short-term follow-up. However, TUMT probably results in a large increase in retreatment rates. Study limitations and imprecision reduced the confidence we can place in these results.

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Prostatic urethral lift for the treatment of lower urinary tract symptoms in men with benign prostatic hyperplasia

Abstract: Prostatic urethral li for the treatment of lower urinary tract symptoms in men with benign prostatic hyperplasia (Review)

Cited by 22 publications

References 67 publications

A state-of-art review on the preservation of sexual function among various minimally invasive surgical treatments for benign prostatic hyperplasia: Impact on erectile and ejaculatory domains

A state-of-art review on the preservation of sexual function among various minimally invasive surgical treatments for benign prostatic hyperplasia: Impact on erectile and ejaculatory domains

Urethral Lift as a Safe and Effective Procedure for Prostatic Hyplasia Population: A Systematic Review and Meta-Analysis

Transurethral Microwave Thermotherapy for Benign Prostatic Hyperplasia: An Updated Cochrane Review

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