Minimally Invasive Prostatic Urethral Lift: Surgical Technique and Multinational Experience |
| |
| Authors: | Thomas A. McNicholas,Henry H. Woo,Peter T. Chin,Damien Bolton,Manuel Ferná ndez Arjona,Karl-Dietrich Sievert,Martin Schoenthaler,Ulrich Wetterauer,Eric J.E.J. Vrijhof,Steven Gange,Francesco Montorsi |
| |
| Affiliation: | 1. Lister Hospital and University of Hertfordshire, Stevenage, UK;2. Sydney Adventist Hospital Clinical School, University of Sydney, Sydney, Australia;3. Figtree Private Hospital, Figtree, NSW, Australia;4. The Austin Hospital, Melbourne, VIC, Australia;5. Hospital Universitario del Henares, Madrid, Spain;6. Eberhard Karls University, Tuebingen, Germany;g University of Freiburg, Freiburg, Germany;h Catharina Hospital, Eindhoven, The Netherlands;i Western Urological Clinic, Salt Lake City, UT, USA;j Università Vita-Salute San Raffaele, Milan, Italy |
| |
| Abstract: | BackgroundMany men with benign prostatic hyperplasia (BPH) are dissatisfied with current treatment options. Although transurethral resection of the prostate (TURP) remains the gold standard, many patients seek a less invasive alternative.ObjectiveWe describe the surgical technique and results of a novel minimally invasive implant procedure that offers symptom relief and improved voiding flow in an international series of patients.Design, setting, and participantsA total of 102 men with symptomatic BPH were consecutively treated at seven centers across five countries. Patients were evaluated up to a median follow-up of 1 yr postprocedure. Average age, prostate size, and International Prostate Symptom Score (IPSS) were 68 yr, 48 cm3, and 23, respectively.Surgical procedureThe prostatic urethral lift mechanically opens the prostatic urethra with UroLift implants that are placed transurethrally under cystoscopic visualization, thereby separating the encroaching prostatic lobes.Outcome measurements and statistical analysisPatients were evaluated pre- and postoperatively by the IPSS, Quality-of-Life (QOL) scale, Benign Prostatic Hyperplasia Impact Index, maximum flow rate (Qmax), and adverse event reports including sexual function.Results and limitationsAll procedures were completed successfully with a mean of 4.5 implants without serious adverse effects. Patients experienced symptom relief by 2 wk that was sustained to 12 mo. Mean IPSS, QOL, and Qmax improved 36%, 39%, and 38% by 2 wk, and 52%, 53%, and 51% at 12 mo (p < 0.001), respectively. Adverse events were mild and transient. There were no reports of loss of antegrade ejaculation. A total of 6.5% of patients progressed to TURP without complication. Study limitations include the retrospective single-arm nature and the modest patient number.ConclusionsProstatic urethral lift has promise for BPH. It is minimally invasive, can be done under local anesthesia, does not appear to cause retrograde ejaculation, and improves symptoms and voiding flow. This study corroborates prior published results. Larger series with randomisation, comparator treatments, and longer follow-up are underway. |
| |
| Keywords: | Benign prostatic hyperplasia Lower urinary tract symptoms Prostatic urethral lift Minimally invasive surgical procedure Prostate Therapy Urethra |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
