Background: Prostatic urethral lift (PUL) using UroLift is new and promising in the treatment of men with lower urinary tract symptoms (LUTS). It has been recently released for clinical use in Korea. This study is to report the initial experience and outcomes of the
Methods: Between December 2016 and November 2017, 31 patients with LUTS due to benign prostatic hyperplasia (BPH) either who were high risk for anesthesia, or wanting to preserve their sexual function, were treated with PUL. Patients were followed up for 3 months. International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), post-void residual urine (PVR), International Index of Erectile Function-5 (IIEF-5), and Male Sexual Health Questionnaire for Ejaculatory Dysfunction Short Form (MSHQ-EjD) were obtained preoperatively and throughout follow-up. Paired t-test and Wilcoxon signed rank test were used for parametric and non-parametric parameters, respectively.
Results: IPSS quality of life (QoL) and total score significantly improved postoperatively and sustained during 3 months (4.5±1.0 vs. 3.3±1.7, P=0.002/19.6±6.3 vs. 14.6±8.6, P=0.018, respectively). Voiding symptoms improved (11.9±4.7 vs. 7.6±5.3, P=0.004), while store symptoms remained unchanged. Qmax and PVR did not change by PUL (10.4±4.7 vs. 11.0±6.1, P=0.300/45.2±64.0 vs. 39.1±35.0, P=0.550). Sexual function was stable or improved, particularly, in regards of confidence, rigidity for penetration and ejaculatory function (2.08±1.2 vs. 2.4±1.2, P=0.050/1.7±1.6 vs. 2.0±1.6, P=0.035/MSHQ-EjD: 10.6±4.6 vs. 9.3±4.9, P=0.040). Most of the adverse events [dysuria: 4 (14.8%), hematuria: 2 (14.8%), urinary retention: 2 (7.4%)] resolved within one or two days. Prostatic abscess occurred to a patient after weeks of the procedure, however, patient fully recovered through transurethral abscess drainage without implants removal.
Conclusions: Our results suggest that PUL is safe and effective in improving LUTS and QoL. It also preserved or even improved sexual functions. The efficacies of PUL sustained during our follow up duration. PUL offers viable option for men with LUTS who desire to maintain sexual function with little adverse events. Further long-term follow up study is warranted.
