MP32-20 PROSTATIC URETHRAL LIFT VS. MEDICAL THERAPY: A META-ANALYSIS EXAMINING SEXUAL FUNCTION OUTCOMES IN MEN WITH BPH

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology II (MP32)1 Apr 2020MP32-20 PROSTATIC URETHRAL LIFT VS. MEDICAL THERAPY: A META-ANALYSIS EXAMINING SEXUAL FUNCTION OUTCOMES IN MEN WITH BPH Claus Roehrborn* and Daniel Rukstalis Claus Roehrborn*Claus Roehrborn* More articles by this author and Daniel RukstalisDaniel Rukstalis More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000876.020AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Erectile dysfunction and retrograde ejaculation are documented risks of surgical and medical therapy for BPH. The prostatic urethral lift (PUL), an effective minimally invasive treatment known to preserve sexual function, challenges the prevalence of medical therapy. Here we combine sexual function outcomes from multiple PUL studies and compare results to daily treatment with an alpha blocker, 5ARI, or combination drug therapy. METHODS: Sexually active men at baseline from the MTOPS study [n=849] and combined PUL studies [L.I.F.T. pivotal trial (L.I.F.T. n=107), sham crossover (Crossover, n=44), trial for obstructive median lobe (MedLift, n=39)] were used for the comparative analysis. MTOPS subjects completed the Brief Male Sexual Function Inventory, a validated questionnaire, whereas PUL subjects completed the SHIM and MSHQ-EjD. All questionnaires have distinct domains that assess erectile and ejaculatory function and sexual satisfaction. Percent change from baseline for these domains were compared among studies at 12, 24, 36 and 48 months. RESULTS: PUL significantly improved ejaculatory function at each timepoint, and erectile function at 12 and 24-months post-treatment (Fig 1). Overall satisfaction in sexual life also improved significantly (by at least 19%) through 48 months post-PUL. In contrast, none of the medical therapies significantly improved erectile or ejaculatory function at any timepoint, and some significantly reduced function. Finasteride significantly reduced erectile function at 48 months, and combination drug therapy significantly reduced ejaculatory function at 12 and 24 months. Comparatively, PUL was superior to finasteride and combination drug therapy at preserving erectile function at 12 and 24 months. Additionally, PUL significantly outperformed all three medical therapies across all timepoints at preserving ejaculatory function. CONCLUSIONS: This meta-analysis of MTOPS and PUL studies, reveals PUL is superior to 5ARIs and combination drug therapy in preserving erectile function through two years post-treatment. For ejaculatory function, PUL outperformed alpha blockers, 5ARIs and combination drug therapy. Only PUL was observed to improve overall satisfaction in sexual life for patients with BPH. Source of Funding: NetoTract, Inc. Teleflex © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e493-e493 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Claus Roehrborn* More articles by this author Daniel Rukstalis More articles by this author Expand All Advertisement PDF downloadLoading ...