1994 PROSTATIC URETHRAL LIFT (PUL) PROVES EFFICACY IN LUTS TREATMENT OF BPH PATIENTS IN DAILY CLINIC PRACTICE OUTSIDE OF STUDIES
2013-03-27

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy and New Technology (II)1 Apr 20131994 PROSTATIC URETHRAL LIFT (PUL) PROVES EFFICACY IN LUTS TREATMENT OF BPH PATIENTS IN DAILY CLINIC PRACTICE OUTSIDE OF STUDIES Florian Miller, Martin Schoenthaler, Richard Berges, Christian Gratzke, Bastian Amend, Jens Bedke, Stephan Kruck, Jürgen Zumbe, Ulrich Wetterauer, Christian Stief, Arnulf Stenzl, and Karl-Dietrich Sievert Florian MillerFlorian Miller Tuebingen, Germany More articles by this author , Martin SchoenthalerMartin Schoenthaler Freiburg, Germany More articles by this author , Richard BergesRichard Berges Koeln, Germany More articles by this author , Christian GratzkeChristian Gratzke Muenchen, Germany More articles by this author , Bastian AmendBastian Amend Tuebingen, Germany More articles by this author , Jens BedkeJens Bedke Tuebingen, Germany More articles by this author , Stephan KruckStephan Kruck Tuebingen, Germany More articles by this author , Jürgen ZumbeJürgen Zumbe Leverkusen, Germany More articles by this author , Ulrich WetterauerUlrich Wetterauer Freiburg, Germany More articles by this author , Christian StiefChristian Stief Muenchen, Germany More articles by this author , Arnulf StenzlArnulf Stenzl Tuebingen, Germany More articles by this author , and Karl-Dietrich SievertKarl-Dietrich Sievert Tuebingen, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2413AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES After conservative treatment fails, TURP is the gold standard for men afflicted by lower urinary tract symptoms(LUTS) caused by benign prostate hyperplasia(BPH), despite periop morbidity rate and possible long-term complications such as stress urinary incontinence and sexual dysfunction. PUL (Urolift®,NeotractInc,CA,USA) offers pat. rapid relief through a minimal invasive surgical technique improving urinary flow and relieving symptoms. Individual sized implants separate the encroaching prostatic lobes placed under endoscopic vision ventrolaterally. We report the preliminary prospective results from a multi-center non-study related outcome. METHODS 37 men with LUTS were treated at 5 centers using general (GA) or local anesthesia (LA). 27 patients were evaluated using prostate volume (PV), Flow max (Qmax), Post void Residual (PVR), International Prostate Symptom Score (IPSS) and Quality of Life (QoL). RESULTS Patient age was 38-85y(68.1±10.5) with a PV of 17-111ml(44.6±24.3). Surgical procedure with 2-7(3.9±1.4) implants was performed within 8-45(20.6±8.8)min. GA was used in 70% of cases. Remaining patients were treated in LA with cold intravesical lidocaine solution (1%) and urethral lidocaine gel. Pat. reported symptom relief within 2 weeks that continued to last follow-up. Only in single cases were dysuria, haematuria recorded, which disappeared within 2 weeks. One pat. reported unchanged frequency and PVR who underwent a second PUL implantation in LA. Current available maximum follow-up is 6 months. Mean Qmax, PVR, IPSS, and QoL significantly improved (p<0.001) within the first month and either improved further or remained unchanged. Sexual function maintained and even improved. There were no case of SUI or retrograde ejaculation postoperative. The patient who received 2nd implants is integrated in the evaluation. Two patients underwent TURP due an unsatisfactory initial outcome. CONCLUSIONS PUL is a minimal invasive surgical technique to alleviate BPH and voiding symptoms. These results are comparable with published clinical studies. It can be performed under LA and does not cause retrograde ejaculation or SUI. A larger patient group comparing treatment outcomes and follow-up are necessary. Pre-operative 1 month post-op⁎⁎ 6 months post-op⁎⁎/a) n=27 n=15 n=9 Qmax (ml) 11.9 +/− 4.4 (6.7-19) 15.2 +/− 5.9 (8-25.2) 18.4 +/− 9.5 (8.4-13.6) PVR (ml) 281.1 +/− 451.5 (40-1600)⁎ 44.6 +/− 65.2 (0-200) 34.3 +/− 36.6 (0-110) IPSS 19.2 +/− 6.6 (8-35) 8.3 +/− 5.4 (2-19) 5.8 +/− 3.3 (2-11) Quality of Life (QoL) 3.6 +/− 1.2 (1-6) 1.3 +/− 0.5 (1-2) 1.3 +/− 1.0 (0-3) α- Blocker 48.6% none none a) insignificant compared to one month ⁎ Four patients had an indwelling catheter ⁎⁎ p< 0.001 compared to pre-op © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e818-e819 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Florian Miller Tuebingen, Germany More articles by this author Martin Schoenthaler Freiburg, Germany More articles by this author Richard Berges Koeln, Germany More articles by this author Christian Gratzke Muenchen, Germany More articles by this author Bastian Amend Tuebingen, Germany More articles by this author Jens Bedke Tuebingen, Germany More articles by this author Stephan Kruck Tuebingen, Germany More articles by this author Jürgen Zumbe Leverkusen, Germany More articles by this author Ulrich Wetterauer Freiburg, Germany More articles by this author Christian Stief Muenchen, Germany More articles by this author Arnulf Stenzl Tuebingen, Germany More articles by this author Karl-Dietrich Sievert Tuebingen, Germany More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...