The Prostatic Urethral Lift for the Treatment of Lower Urinary
Tract Symptoms Associated with Prostate Enlargement
Due to Benign Prostatic Hyperplasia: The L.I.F.T. Study
Claus G. Roehrborn,*,† Steven N. Gange,† Neal D. Shore,† Jonathan L. Giddens,
Damien M. Bolton,† Barrett E. Cowan, B. Thomas Brown,† Kevin T. McVary,†
Alexis E. Te,† Shahram S. Gholami,† Prem Rashid, William G. Moseley,†Peter T. Chin,† William T. Dowling, Sheldon J. Freedman, Peter F. Incze,‡
K. Scott Coffield, Fernando D. Borges and Daniel B. Rukstalis†
From the University of Texas Southwestern Medical Center, Dallas, and Scott and White Healthcare, Temple, Texas;
Western Urological Clinic, Salt Lake City, Utah; Carolina Urological Research Center, Myrtle Beach, South Carolina;
Cosmetic Surgery Hospital, Brampton, and Oakville Trafalgar Memorial Hospital, Oakville, Ontario, Canada; The Austin Hospital,
Melbourne, Victoria, Australia, Urology Associates of Denver, Denver, Colorado; Atlantic Urological Associates, Daytona Beach,and Pinellas Urology, St. Petersburg, Florida; Northwestern University and Southern Illinois University, Springfield, Illinois;
Weill Cornell Medical Center, New York, New York; Urology Associates of Silicon Valley, San Jose, and SD Uro-Research,
San Diego, California; Port Macquarie Hospital, Port Macquarie, and Figtree Private Hospital, Figtree, New South Wales, Australia;
Chesapeake Urology, Baltimore, Maryland; Freedman, MD, LTD, Las Vegas, Nevada; and Geisinger Medical Center and Wake
Forest University, Winston-Salem, North Carolina

Purpose: We report the first multicenter randomized blinded trial of the prostatic urethral lift for the treatment of lower urinary tract symptoms secondary tobenign prostatic hyperplasia.
Materials and Methods: Men at least 50 years old with AUASI (American
Urological Association Symptom Index) 13 or greater, a maximum flow rate
12 ml per second or less and a prostate 30 to 80 cc were randomized 2:1 between
prostatic urethral lift and sham. In the prostatic urethral lift group small permanent implants are placed within the prostate to retract encroaching lobes andopen the prostatic urethra. Sham entailed rigid cystoscopy with sounds
mimicking the prostatic urethral lift. The primary end point was comparison of
AUASI reduction at 3 months. The prostatic urethral lift arm subjects were
followed to 1 year and assessed for lower urinary tract symptoms, peak urinary
flow rate, quality of life and sexual function.
Results: A total of 206 men were randomized (prostatic urethral lift 140 vssham 66). The prostatic urethral lift and sham AUASI was reduced by 11.1 
7.67 and 5.9  7.66, respectively (p ¼ 0.003), thus meeting the primary end
point. Prostatic urethral lift subjects experienced AUASI reduction from
22.1 baseline to 18.0, 11.0 and 11.1 at 2 weeks, 3 months and 12 months,
respectively, p <0.001. Peak urinary flow rate increased 4.4 ml per second at
3 months and was sustained at 4.0 ml per second at 12 months, p <0.001.

Abbreviations
and Acronyms
AE ¼ adverse event
BPH ¼ benign prostatic
hyperplasia
BPHII ¼ BPH Impact Index
IIEF ¼ International Index of
Erectile Function
ITT ¼ intent to treat
LUTS ¼ lower urinary tract
symptoms
MSHQ-EjD ¼ Male Sexual Health
Questionnaire for Ejaculatory
Dysfunction
PUL ¼ prostatic urethral lift
PVR ¼ post-void residual volume
Qmax ¼ peak urinary flow
QOL ¼ quality of life
TURP ¼ transurethral resection of
the prostate

Accepted for publication May 30, 2013.
Study received institutional review board approval.
* Correspondence: Department of Urology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., J8-130, Dallas, Texas 75390-9110(e-mail: Claus.Roehrborn@UTSouthwestern.edu).
† Financial interest and/or other relationship with NeoTract.
‡ Financial interest and/or other relationship with The Fe/Male Health Centre.

See Editorial on page 1976.

0022-5347/13/1906-2161/0
THE JOURNAL OF UROLOGY®
© 2013 by AMERICAN UROLOGICAL ASSOCIATION EDUCATION AND RESEARCH, INC.

http://dx.doi.org/10.1016/j.juro.2013.05.116
Vol. 190, 2161-2167, December 2013
Printed in U.S.A.

www.jurology.com j 2161

2162

RANDOMIZED STUDY OF PROSTATIC URETHRAL LIFT FOR BENIGN PROSTATIC HYPERPLASIA

Adverse events were typically mild and transient. There was no occurrence of de novo ejaculatory or erectile
dysfunction.
Conclusions: The prostatic urethral lift, reliably performed with the patient under local anesthesia, provides
rapid and sustained improvement in symptoms and flow, while preserving sexual function.
Key Words: prostate; prostatic hyperplasia; urethra; surgical procedures,
minimally invasive; therapeutics

BOTHERSOME LUTS due to BPH affect 30% of men
older than 50 years including 8 million men in the
United States.1,2 All currently available treatments
have a balance of risks and benefits, leaving a large
chasm between medical and surgical options. Medical therapy provides a modest 3.5 to 7.5 AUASI
improvement at 1 year. However, bothersome side
effects or inadequate relief prompt 30% of men to
discontinue treatment.1,2 Transurethral resection of
the prostate, considered the surgical gold standard
for BPH, offers a 14.9 AUASI improvement, but
this improvement comes with a 20% perioperative
morbidity rate and long-term complications that
include incontinence (3%), strictures (7%), erectile
dysfunction (10%) and loss of ejaculatory function(65%).3,4 While new laser based modalities havedemonstrated decreased bleeding, they are associated with morbidity rates similar to TURP.4,5
The prostatic urethral lift has emerged in theliterature as potentially offering rapid and significant
mitigation of LUTS while maintaining a morbidity
profile considerably better than that of surgicalresection or ablation, including a unique preservation of sexual function.6e10 Permanent intraprostatic
UroLiftÒ implants (NeoTract, Inc., Pleasanton,
California) are delivered to separate encroachinglateral prostate lobes and relieve obstruction without
thermal injury or resection of prostatic tissue. Single
arm studies show an AUASI reduction considerablylarger than drugs, faster acting than thermal therapies and without serious complications associatedwith TURP or laser.6e9 We report the first multicenter randomized controlled and blinded study of
PUL. This study encompasses 19 centers in 3 countries and is entitled L.I.F.T. (Luminal Improvement
Following Prostatic Tissue Approximation for theTreatment of LUTS secondary to BPH).

2.9 mm 0 degree lens, the delivery device is angled anterolaterally to compress the obstructive lobe. A 19 gauge
needle, housing a monofilament with metallic tab, is thendeployed through the prostate lobe. As the needle isretracted, the tab engages the prostate capsule and themonofilament is tensioned. Finally, the urethral end-pieceis attached to the monofilament, which is then cut,delivering the in situ sized implant. Because the fibromuscular capsule is less compliant than the periurethral
tissue, the capsular tab holds firmly in place while theurethral end-piece holds the lobe in its displaced position
thus expanding the urethral lumen. When implanted, theurethral end-piece invaginates into the urethral wall
where focal injury promotes epithelialization (fig. 2). The
objective of the PUL is to create a channel through theanterior aspect of the prostatic fossa.
The sham control procedure was conducted with as
similar an experience as possible. For all active and control procedures, a surgical drape was used so that the
subject could not see the surgeon or endoscopic image. Asa rigid cystoscopy was performed, the surgeon called for
devices that were opened but not deployed. A disposable
biopsy device was not inserted, but was deployed 4 times
to simulate the device sounds.

Study Protocol and Objectives
A prospective, randomized, controlled, blinded study ofthe prostatic urethral lift procedure was conducted inmen with symptomatic BPH. The U.S. Food and Drug
Administration, Health Canada and the Therapeutic
Goods Administration of Australia approved the study, as
did institutional review boards at each of the 19 enrollingsites (Clinicaltrials.gov: NCT01294150). The primaryobjective was to determine the safety and efficacy of the
PUL to support U.S. market approval for the implant

MATERIALS AND METHODS
The prostatic urethral lift Procedure
During the prostatic urethral lift procedure, transprostatic adjustable UroLift implants are permanently
implanted to retract obstructing lateral lobes and expand
the urethral lumen (fig. 1).6e10 After rigid cystoscopy is
performed, the implant delivery device is inserted into
the 20Fr sheath. Under cystoscopic visualization using a

Figure 1. PUL procedure effect showing prostate obstructedby BPH (A) and after procedure with permanent implants
retracting prostatic tissue and increasing prostatic urethrallumen (B).

RANDOMIZED STUDY OF PROSTATIC URETHRAL LIFT FOR BENIGN PROSTATIC HYPERPLASIA

2163

Figure 2. Cystoscopic view of PUL before treatment (A), at end of procedure (B) and 1 year after treatment (C ). Implant invaginates into
prostatic urethral wall (arrow) leaving epithelialized permanent channel in prostatic fossa.

technology. An independent data monitoring committee
assessed safety, and all AEs were adjudicated andassessed by an independent clinical events committee. An
independent central reviewer over-read all uroflow waveforms, calculating Qmax using the 2-second rule,11 andevaluated all cystoscopy videos from baseline and 1 year. A
double-blind was maintained through the 3-month end
point with the patient and questionnaire administrator
blinded to randomization. Blinding of participants wastested upon discharge and at each followup to 3 months.
Eligible subjects were at least 50 years old, provided
informed consent, had no prior surgical treatment for
BPH, and were required to undergo washouts of 2 weeks
for a-blocker, 3 months for 5a-reductase inhibitor and3 days for anticoagulants. Admission to the study
required AUASI 13 or greater, Qmax 12 ml per second orless with a 125 ml voided volume and a 30 to 80 cc prostate. Subjects were excluded for median lobe obstruction,
retention, PVR greater than 250 ml, active infection,
prostate specific antigen greater than 10 ng/ml (unlessnegative biopsy), cystolithiasis within 3 months and bacterial prostatitis within 1 year.
The primary efficacy end point was to demonstrate, on
an ITT basis, that the reduction in AUASI at 3 months
after the PUL procedure was at least 25% greater thanthat of sham. All subjects in the PUL group were followed
through 1 year to evaluate durability of effect. QOL,BPHII, IIEF and the MSHQ-EjD were assessed at 2
weeks and at 1, 3, 6 and 12 months. Qmax and PVR wereassessed at 3 and 12 months. The protocol calls for followup visits on an annual basis to 5 years. All subjects
were unblinded after the 3-month end point and control
patients were offered the PUL or other intervention if
symptoms persisted. The long-term results from thesepatients will be presented in a separate report.

To evaluate per protocol change from baseline a general estimating equation model was fit to each output
parameter. Change from baseline was the dependent
variable; visit and baseline score were used as independent variables. An exchangeable correlation structure andidentity link were used. This model was used to calculate
p values for each followup interval compared to baseline.

RESULTS
Procedure
Between February and December 2011, 206 men
were 2:1 randomized and treated with the PUL(140) or sham control (66) across 19 centers (UnitedStates 14, Canada 2, Australia 3). Baseline demographics were similar among randomized groups(table 1). All subjects were evaluated for the ITT
primary end point at 3 months with 2 subjects
counted as zero change due to initiating BPH
medication (fig. 3). After the randomized comparison followup, all subjects were unblinded. Of 66
control subjects 53 later elected to undergo the PUL
procedure and followup will be detailed in anotherreport. There were 123 PUL subjects included in theper protocol analysis at 12 months. Five subjects
elected to undergo PUL revision due to insufficient
response. Two subjects elected subsequent prostate
resection. Seven subjects were censored due to useof BPH medication. One subject discontinued
participation and 2 were excluded from study due tosignificant protocol deviations.
Table 1. Subject demographics

Statistical Methods
Randomization was conducted just before treatmentusing permuted blocks of various sizes chosen at random
through a central electronic data program. The study was
powered for the primary end point assuming a Student’s
t test comparison of mean values on an ITT basis, 0.05
2-sided type 1 error and 80% statistical power. AUASI
reductions for the PUL and sham were estimated fromavailable literature. For ITT analysis, any subject that
underwent additional BPH therapy (procedure or medications) was treated as a treatment failure and was
assigned a zero reduction from baseline.

PUL Group Mean (SD) Control Group Mean (SD)Age
Ht (in)Wt (lbs)
Body mass index (kg/m2)
Prostate vol (cc)
AUASI
Qmax (ml/sec)
PVR (ml)
QOL
Prostate specific antigen (ng/ml)
IIEF-5
MSHQ-EjD

67 (8.6)
70.1 (2.5)
197.3 (30.7)
28.3 (4.2)
44.5 (12.4)
22.2 (5.4)
8.9 (2.2)
85.5 (69.2)
4.6 (1.1)
2.4 (2.0)
13.0 (8.4)
8.7 (3.2)

65 (8.0)
69.4 (3.6)
187.8 (30.2)
27.4 (3.6)
40.9 (10.8)
24.4 (5.8)
8.8 (2.2)
87.7 (72.4)
4.7 (1.1)
2.1 (1.6)
13.5 (8.5)
8.8 (3.2)

2164

RANDOMIZED STUDY OF PROSTATIC URETHRAL LIFT FOR BENIGN PROSTATIC HYPERPLASIA

guessing they underwent PUL or were not sure atpoint of discharge. This rate remained at 57% at
3 months followup. Only 4 subjects were unblindedwithin 3 months.
Efficacy
The primary end point was met at 3 months AUASI
reduction being at least 25% greater for the PUL
than that of control (p ¼ 0.003, fig. 4). The mean
AUASI reduction for the PUL was 88% greaterthan sham control. In addition to AUASI, PUL
therapeutic effects were significantly better thancontrol with regard to Qmax, QOL and BPHII(table 2). There was no statistical difference between
groups with regard sexual function. PUL AUASI
reduction was clinically and statistically significant
by 2 weeks, further improved to 3 months and wassustained at 1 year (table 3). Durability of effect was
further tested by comparing cumulative frequency
of AUASI change at 6 and 12 months (fig. 5).

Figure 3. CONSORT (CONsolidated Standards of Reporting
Trials) flow diagram of L.I.F.T. study.

All procedures were successfully completed withno perioperative serious AEs. Overall PUL procedure time was 66.2  23.8 minutes, while that forcontrol was 46.8  17.2. An average of 4.9 implants(range 2 to 11) was delivered in prostates ranging
from 30 to 77 cc. While Australian standard of care
dictated general anesthesia, in North America 168
of 169 procedures were conducted with the patientunder local anesthesia. Only 4 procedures used aperiprostatic block and the remainder used 10 mg
oral diazepam 30 minutes before the procedure andinstillation of (4C) 2% lidocaine liquid to the bladdervia catheter and cold 2% lidocaine gel to the urethra. The penis was then clamped for 20 minutes. A
nurse engaged the conscious patient behind thesurgical drape. Postoperative catheterization was
administered in 40 PUL subjects as a standard ofcare. Of the remaining 100 subjects 68 (68%)
required no catheter after void trial and the mean
duration of catheterization was 0.9 days. PUL subjects reported a return to preoperative activity levelas 8.6  7.5 days, compared to 3.1  4.4 days forcontrol. Blinding and the sham procedure weresuccessful with more than 80% of control subjects

SafetyTwo serious AEs were adjudicated as related to theprocedure (table 4). The first entailed an overnight
stay for clot retention coincident with reinitiating
warfarin therapy, and the second was a subject who
required removal of a bladder stone at 12 months
that had formed from confirmed bladder gravel atbaseline and was not associated with an implant.
One subject died of unrelated causes as adjudicatedby clinical events committee and data monitoring
committee. Less serious AEs (postoperative dysuria,
hematuria, pain/discomfort and urgency) weretypically mild to moderate and resolved within
2 weeks. There was no incidence of de novo sustained ejaculatory or erectile dysfunction.

Figure 4. Comparison of AUASI score throughout blindedperiod for subjects randomized to PUL arm and sham control
arm. Values shown are mean and error bars represent 95% CI.
All points reflect ITT population of 140 PUL and 66 control
subjects.

RANDOMIZED STUDY OF PROSTATIC URETHRAL LIFT FOR BENIGN PROSTATIC HYPERPLASIA

2165

Table 2. Comparison of mean change in outcomes at 3 months
PUL-ITT Group Mean, SD (No. responses)

Control ITT Group Mean, SD (No. responses)

Outcome
MeasureBaseline

3 Mos

ChangeBaseline

3 Mos

Changep Value(2-sample t - test)

AUASI
Qmax (ml/sec)
QOL
BPHII
MSHQ-EjD
MSHQ-Bother
IIEF-5
PVR (ml)

22.2, 5.48 (140)8.02, 2.43 (126)
4.6, 1.1 (140)
6.9, 2.8 (140)8.7, 3.1 (94)
2.4, 1.7 (117)
13.3, 8.4 (132)85.5, 69.2 (140)11.2, 7.65 (140)12.29, 5.40 (126)
2.4, 1.7 (140)3.0, 3.1 (140)10.9, 3.2 (94)
1.6, 1.7 (117)
13.4, 9.2 (132)75.8, 83.9 (140)11.1, 7.67 (140)
4.28, 5.16 (126)2.2, 1.8 (140)3.9, 3.2 (140)
2.2, 2.5 (94)
0.8, 1.5 (117)0.1, 5.8 (132)9.7, 85.5 (140)24.4, 5.75 (66)
7.93, 2.41 (56)
4.7, 1.1 (66)7.0, 3.0 (66)8.8, 3.1 (50)
2.2, 1.7 (60)
13.7, 8.5 (65)85.6, 70.8 (65)

18.5, 8.59 (66)
9.91, 4.29 (56)
3.6, 1.6 (66)
4.9, 3.2 (66)10.5, 3.5 (50)
1.5, 1.7 (60)15.2, 8.5 (65)63.4, 64.0 (65)

5.9, 7.66 (66)
1.98, 4.88 (56)
1.0, 1.5 (66)
2.1, 3.3 (66)
1.7, 2.6 (50)
0.7, 1.6 (60)
1.5, 6.4 (65)22.2, 70.7 (65)

0.003
0.005
<0.001<0.001
0.283
0.595
0.139
0.306

Of the 140 PUL subjects 131 (94%), with a totalof 642 implants, agreed to undergo cystoscopy at
12 months. Independent video review, conducted
on 127 available videos, found no strictures, amild increase in inflammation and edema in only
1 and 5 patients, respectively, and no evidenceof abnormal pathology. There was no evidence of
encrustation on implants delivered within theprostate. Encrustation was observed on 14 (2.1%)
implants in 10 subjects that were inadvertently
delivered such that part of the implant was exposed
inside the bladder. An additional 13 implants
showed some exposure to the bladder with noencrustation. One encrusted implant was later
removed with endoscopic forceps.

DISCUSSION
The results of this randomized study confirm that
the PUL can offer rapid and durable LUTS relief
with minimal morbidity and no compromise of sexual function. AUASI was reduced from baseline by 4
points at 2 weeks, reached 11 points by 3 months
and remained stable to 1 year. Qmax improvement(4 ml per second) was both clinically and statistically significant. The formidable sham effect

Table 3. Change in outcomes from baseline through 1 year

AUASI:
No. (paired)
Mean  SD baseline
Mean  SD followup
Change% Change (95% CI)
p ValueQOL:
No. (paired)
Mean  SD baseline
Mean  SD followup
Change% Change (95% CI)
p Value
BPHII:
No. (paired)
Mean  SD baseline
Mean  SD followup
Change% Change (95% CI)
p Value
Qmax (ml/sec):
No. (paired)
Mean  SD baseline
Mean  SD followup
Change% Change (95% CI)
p Value
PVR (ml):No. (paired)
Mean  SD baseline
Mean  SD followup
Change% Change (95% CI)
p Value

2 Wks

1 Mo

3 Mos

6 Mos

12 Mos137
22.1  5.4
18.0  7.9
4.1
17 (10 e 24)
<0.0001137
22.1  5.4
12.3  6.9
9.8
44 (38 e 49)
<0.0001137
22.1  5.4
11.0  7.6
11.1
50 (44 e 56)
<0.0001133
21.9  5.4
11.0  7.3
10.9
49 (43 e 55)
<0.0001

123
21.8  5.4
11.1  7.0
10.8
49 (42 e 55)
<0.0001137
4.6  1.1
3.6  1.6
1.0
17 (9 e 26)
<0.0001137
4.6  1.1
2.6  1.7
2.0
42 (35 e 49)
<0.0001137
4.6  1.1
2.4  1.7
2.2
47 (39 e 54)
<0.0001133
4.6  1.1
2.1  1.7
2.4
52 (45 e 59)
<0.0001123
4.5  1.0
2.2  1.6
2.4
51 (45 e 58)
<0.0001137
6.8  2.8
7.0  3.4
0.2
þ3.1 (0.7 e 5.4)
0.613

137
6.8  2.8
4.0  3.1
2.8
33 (18 e47)<0.0001137
6.8  2.8
2.9  3.0
3.9
56 (47 e 65)
<0.0001133
6.8  2.8
2.6  2.8
4.2
60 (52 e 68)
<0.0001123
6.6  2.8
2.7  2.9
4.0
59 (49 e 68)
<0.0001124
8.1  2.4
12.4  5.4
4.4
64(48 e 80)<0.0001103
8.1  2.4
12.1  5.4
4.0
59(41e77)<0.0001137
83  6772  811140 (11 e 91)
0.1460120
82  66
70  9812(18e54)18
0.1111

2166

RANDOMIZED STUDY OF PROSTATIC URETHRAL LIFT FOR BENIGN PROSTATIC HYPERPLASIA

Figure 5. Cumulative frequency distribution of subjects
achieving AUASI reduction at 6 and 12 months. Cumulative
frequency shows percent of subjects (y axis) achieving each
AUASI change (x axis). Decreasing durability would show
rightward shift in data from 6 to 12 months but instead data
are superimposable.

observed in this study and in the literature is likely
due to a combination of placebo, dilation andregression.12e16 Nevertheless, PUL treatment effectwas considerably and statistically greater in allmeasures. Covariate analysis using an ANCOVA
model showed no effect of prostate volume on thisresult. Stable erectile function and the absence of
ejaculatory dysfunction suggest that this tissue
sparing approach does not cause the adverse sexualfunction effects that accompany other BPH therapies.3,17 The low morbidity and ability to conduct
the procedure with the patient under local anesthesia suggest that the PUL may offer benefits inthe treatment of LUTS secondary to BPH.
This study demonstrates the durability of the
PUL to 1 year and AUASI improvement corroborates

prior 2-year results.6,8 The 5% re-treatment rate
at 1 year is similar to prior reports showing 6% at
1 year and 8% at 2 years.6,8 Two subjects (1.4%)
were treated with TURP and laser vaporization
without difficulty or complication, as with priorreports.6e8 Five PUL revisions were conductedroutinely with good acute results. Figure 5 offers amethod by which to predict long-term durability.
Decreasing durability would show a rightward shift
in the data from 6 to 12 months but instead thedata are superimposable. This protocol will continue
to follow subjects an additional 4 years to confirm
the predicted stability of effect.
Intensive inspection was given to long-term
cystoscopic examination of the implants, demonstrating biocompatibility and no occurrence of
encrustation within the prostatic urethra. It is
important to note that this procedure does require
surgical skill and decision making gained fromexperience. Misplacement of the implant suchthat it is exposed to bladder urine may result in
encrustation. Closely adhering to the technique of
implant delivery no closer than 1 cm to the bladderneck and insuring appropriate angulation can avoid
this issue. We recommend that at the end of each
PUL procedure, the operator inspect the bladderinterior to confirm that no implants are exposed. If
detected, the misplaced implant can be easily
removed with endoscopic forceps.
Preservation of ejaculatory function has beenshown to be of importance to men and has recently
become a focus in evaluating BPH therapies, bothinterventional and medical.18e21 No PUL subjects
experienced de novo sustained erectile dysfunction
or anejaculation. We believe this result to be an
important advantage of the PUL. If a man achieves
LUTS relief yet the treatment impacts the ability toperform sexually, the overall quality of life may not
be improved.

Table 4. Overview of adjudicated adverse events
PUL Group 0-3 Mos

Serious AEs
Related seriasAE
All AEs
Related AEc
Dysuria
Hematuria
Pelvic pain/discomfort
Urgency
Bladder spasm
Urge incontinence
Urinary tract infection
Retention
Erectile dysfunction
Retrograde ejaculation

Control Group 0-3 Mos

PUL Group 3-12 Mos

No. Events

No. Subjects (%)

No. Events

No. Subjects (%)

No. Events

No. Subjects (%)

9
1
268
203

7 (5.0)1 (0.7)122 (87.1)
113 (80.7)
48 (34.3)
36 (25.7)
25 (17.9)
10 (7.1)
5 (3.6)5 (3.6)4 (2.9)1 (0.7)
0 (0)
0 (0)

1
0
53
26

1 (1.5)0 (0)34 (51.5)
20 (30.3)
11 (16.7)
3 (4.5)3 (4.5)0 (0)0 (0)1 (1.5)
1 (1.5)
1 (1.5)
0 (0)
0 (0)

16
1
144
44

16 (11.4)
1 (0.7)73 (52.1)
35 (25.0)
1 (0.7)1 (0.7)2 (1.4)3 (2.1)1 (0.7)1 (0.7)0 (0)1 (0.7)
0 (0)
0 (0)

RANDOMIZED STUDY OF PROSTATIC URETHRAL LIFT FOR BENIGN PROSTATIC HYPERPLASIACONCLUSIONSThe prostatic urethral lift provides a clinicallymeaningful improvement in LUTS secondary to
BPH and urinary flow. The procedure canreliably be performed with the patient under2167

local anesthesia with low morbidity and preservesof all aspects of sexual function. This rapidly
acting and minimally invasive treatment offers
attractive benefits for the treatment of symptomatic BPH.

REFERENCES
1. Roehrborn CG: Current medical therapies formen with lower urinary tract symptoms andbenign prostatic hyperplasia: achievements andlimitations. Rev Urol 2008; 10: 14.
2. Verhamme KM, Dieleman JP, Bieumink GS et al:
Treatment strategies, patterns of drug use andtreatment discontinuation in men with LUTS
suggestive of benign prostatic hyperplasia: theTriumph Project. Eur Urol 2003; 58: 539.
3. Roehrborn CG, McConnell JD, Bary MJ et al:
American Urological Association Guideline:
Management of benign prostatic hyperplasia(BPH). American Urological Association Education and Research Inc. 2003.
4. McVary KT, Roehrborn CG, Avins AL et al:
American Urological Association Guideline:
Management of benign prostatic hyperplasia(BPH). American Urological Association Education and Research Inc. 2010.
5. Thangasamy IA, Chalasani V, Bachmann A et al:
Photoselective vaporisation of the prostate using
80-W and 120-W laser versus transurethralresection of the prostate for benign prostatic
hyperplasia: a systematic review with metaanalysis from 2002 to 2012. Eur Urol 2012; 62:315.
6. McNicholas TA, Woo HH, Chin PT et al: Minimally invasive prostatic urethral lift: surgical
technique and multinational experience. Eur Urol
2013; 64: 292.
7. Woo HH, Chin PT, McNicholas TA et al: Safety
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