AUA 2017: 5 Year Prospective, Randomized, Controlled Study Results on the Minimally Invasive Prostatic Urethral Lift (PUL)

Boston, MA ( Secondary to benign prostatic hyperplasia, the Prostatic Uretheral Lift (PUL) has been shown to rapidly reduce lower urinary tract symptoms (LUTS) with minimal side effects. PUL is currently the only mechanical device that is available without any type of heat applica-tion to treat BPH. This data presented is the end of the PUL study which was presented 5 years ago.

There were 206 male patients in this study with criteria being ≥ 50 years of age as well as an IPSS score of ≥ 13. The prostate vol-ume had to be between 30-80cc and the peak flow rate ≤ 12 ml/s. Pa-tients were randomized to either PUL or control. Both the patients and the assessors were blinded to treatment arm for 3 months. After PUL, a minimally invasive surgery, is implemented, permanent im-plants retract the lateral loves to open the prostatic fossa enlarging the uretheral lumen.

After 5 years, 104 patients were remaining. IPSS (7.6 or 36% from baseline), QOL (2.3 or 50% from baseline), and Qmax ( 3.5mL/s or 44% from baseline) remain improved and re-treatment is rare (2% to 3% per year over 5 years). Local anesthesia was well tolerated. PUL avoided incontinence and sexual side effects or sexual dysfunc-tion including ejaculatory dysfunction. It took 8.6 days to recover to normal functionality with rapid symptom relief. 68% of the patients re-ceived no post-operative catheter. After one year, a cystoscopy was conducted and videos were reviewed showing no evidence of encrus-tation on implants in the prostatic urethra. Overall, there was an im-provement in symptoms, quality of life, and flow durable over the 5 years due to this minimally invasive surgery.

Presented By: Claus Roehrborn, MD

Authors: Claus Roehrborn, MD, Neal Shore, Steven Gange, Daniel B Rukstalis,

Affiliation: UT Southwestern Medical Center, Atlantic Urology Clin-ics, Department of Urology, Wake Forest University

Written By: Kheira Bettir, University of Irvine, California for

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA