Scottsdale, Arizona (UroToday.com) This was a retrospective analysis to examine Prostatic Urethral Lift (PUL) effectiveness through retrospective analysis of commercial PUL cases across multiple centers.
There were 1,413 consecutive PUL performed on patients in North America and Australia. Baseline demographics and symptom outcomes of real-world retrospective (RWR) subjects were compared to subjects in the randomized L.I.F.T. study. IPSS, QoL and Qmax were evaluated at 1,3,6,12 & 24-months post-procedure for all non-urinary retention subjects (Group A) and retention subjects (Group B). Within Group A, outcomes were further analyzed using paired t-tests and 95% mean confidence intervals for the following parameters: PSS baseline ≥ 13, age, prostate size, site of service, prostate cancer treatment, and diabetic status. Interventions, adverse events, and catheterization rates were summarized.
RWR subjects were older, had lower baseline IPSS and QoL and higher Qmax compared to those from the L.I.F.T. study. Following PUL, mean IPSS for Group A improved significantly from baseline by at least 8.1 points throughout follow up and 84% of subjects required no catheter. No significant differences were observed between Group A and B absolute symptom scores. Within Group A cohorts, subjects with an IPSS baseline ≥ 13 behaved similarly to L.I.F.T (Figure 1). Age (<50 vs ≥50yr), prostate volume (<30cc or ≥80cc), site of service, prior cancer treatment, and diabetic status did not significantly impact PUL effectiveness outcomes. Previous prostate cancer treatment did not elevate adverse events of high concern such as incontinence and infection. When completed in a clinic office resulted in fewer side effects and catheter placement compared to other sites of service.
The authors reported that this was the largest study of a MIST procedure for BPH in a real-world setting and confirm clinical study results. Patients not previously examined (e.g. in retention, with large prostates, history of diabetes and prostate cancer) can be treated safely and effectively with PUL.
Presented by: Daniel Jaffee, MD, Affiliated Urologist, Pheonix, Arizona
Co-Authors: Gregg Eure, MD,2 Steven Gange, MD,3 Douglas Grier, MD4
2. Urology of Virginia
3. Summit Urology Group
4. Sound Urological Associates
Written by: Bilal Farhan, MD, Assistant Professor, Division of Urology, University of Texas, Medical Branch, Texas; @BilalfarhanMD, at the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction Winter Meeting, SUFU 2020, February 25 - February 29, 2020, Scottsdale, Arizona