MP76-17 SUCCESSFUL OUTCOMES IN ACUTE URINARY RETENTION (AUR) PATIENTS TREATED WITH THE PROSTATIC URETHRAL LIFT (PUL) ARE ASSOCIATED WITH EARLIER INTERVENTION

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP76-17 SUCCESSFUL OUTCOMES IN ACUTE URINARY RETENTION (AUR) PATIENTS TREATED WITH THE PROSTATIC URETHRAL LIFT (PUL) ARE ASSOCIATED WITH EARLIER INTERVENTION Oliver (Olly) Kayes, Neil Barber, Rajesh Kavia, Toby Page, Nikesh Thiruchelvam, Gregg Eure, and Mark Rochester Oliver (Olly) KayesOliver (Olly) Kayes More articles by this author , Neil BarberNeil Barber More articles by this author , Rajesh KaviaRajesh Kavia More articles by this author , Toby PageToby Page More articles by this author , Nikesh ThiruchelvamNikesh Thiruchelvam More articles by this author , Gregg EureGregg Eure More articles by this author , and Mark RochesterMark Rochester More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003350.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: AUR represents a subset of difficult patients with BPH-LUTS who require rapid restoration of voiding. Shifting to a day case procedure such as PUL with demonstrated safety and efficacy in AUR patients, may accelerate treatment pathways without compromising patient outcomes. As such, appropriate selection criteria are desired to help urologists better gauge how AUR patients may respond to PUL. Here, we examine patient and procedural characteristics that underpin treatment success in AUR patients who underwent PUL. METHODS: A logistical regression model was constructed to evaluate factors associated with outcomes predicting success following PUL (i.e., catheter and surgery free at 12 months). Covariates for subjects in the PULSAR study (single arm PUL in AUR; n=51) as well as retention patients in the real-world registry (RWRr; n=388) included age, prostate volume, proxies of BPH disease severity (IPSS, IPSS QoL, Qmax, PSA, PVR), medical history (duration of catheterization), and procedural details (implants placed, procedure time, voiding efficiency). Results were reported as odds ratio point estimates with statistical significance quantified using chi-squared tests. RESULTS: After PUL, 73% of PULSAR subjects were catheter and surgery free at 12 months with success associated with higher voiding efficiency during the perioperative period. Slightly higher catheter-free rates (80%) were seen in RWRr patients and variables that influenced success encompassed age <70 years at procedure, lower baseline PSA, lower baseline PVR, and shorter pre-procedural catheter duration. Logistic regression for the combined PULSAR and RWRr retention groups revealed success associated with procedural age <70 yr and higher voiding efficiency. Stepwise multivariate regression analysis did not reveal any significant associations (Table 1). CONCLUSIONS: Advanced age, higher baseline PSA and PVR, and longer pre-procedure catheter durations drive suboptimal PUL outcomes in AUR patients. Voiding efficiencies following PUL may also help to ascertain long-term response after treatment. In men deemed suitable for PUL treatment, these new selection criteria may provide more men in AUR with earlier access to safe and effective BPH surgery. Source of Funding: Teleflex, Inc © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1098 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Oliver (Olly) Kayes More articles by this author Neil Barber More articles by this author Rajesh Kavia More articles by this author Toby Page More articles by this author Nikesh Thiruchelvam More articles by this author Gregg Eure More articles by this author Mark Rochester More articles by this author Expand All Advertisement PDF downloadLoading ...