To assess the efficacy of the prostatic urethral lift (PUL) procedure for treating lower urinary tract symptoms (LUTS) in men with a history of prostate irradiation.
A retrospective review was performed on patients who underwent PUL following radiation therapy between November 2019 and November 2025. Preoperative and postoperative patient-reported symptom scores, uroflowmetry, post-void residual (PVR), catheter utilization, and need for lower urinary tract symptoms (LUTS) medications were compared to assess the efficacy of the procedure in this cohort.
A total of 41 patients were included in the analysis. The proportion of patients requiring catheterization declined from 51.2% preoperatively to 23.1% at one year postoperatively (p=0.002). The mean International Prostate Symptom Score (IPSS) improved from 17.8 preoperatively to 12.9 at one-year follow-up (p=0.028). The mean IPSS Quality of Life score improved from 4.5 preoperatively to 2.7 at one-year follow-up (p<0.001). PVR decreased from a mean of 215.9 mL preoperatively to 126.0 mL at one year (p=0.093). The procedure did not significantly lower the need for LUTS medications (p=0.867).
The PUL procedure may offer durable symptomatic benefit and improved urinary function in carefully selected patients with a history of prostate irradiation.
Urology. 2026 Jul 16 [Epub ahead of print]
Alex Yonkman, Sarah Schrup, Makena Rodriguez, Sarah C McGriff, Jonathan N Warner
Alix School of Medicine, Mayo Clinic, Rochester, MN 55905, United States. Electronic address: ., Department of Urology, Mayo Clinic, Rochester, MN 55905, United States. Electronic address: ., Alix School of Medicine, Mayo Clinic, Rochester, MN 55905, United States; Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN 55905, United States. Electronic address: ., Department of Urology, Mayo Clinic, Rochester, MN 55905, United States. Electronic address: ., Department of Urology, Mayo Clinic, Rochester, MN 55905, United States. Electronic address: .