PD23-03 FAILURE OF PROSTATIC URETHRAL LIFT BASED ON SUBSEQUENT MEDICAL AND/OR SURGICAL MANAGEMENT: DATA FROM A L.I.F.T. STUDY CENTER

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology IV (PD23)1 Sep 2021PD23-03 FAILURE OF PROSTATIC URETHRAL LIFT BASED ON SUBSEQUENT MEDICAL AND/OR SURGICAL MANAGEMENT: DATA FROM A L.I.F.T. STUDY CENTER Rahul Dutta, Ethan Matz, Nicholas Deebel, Elizabeth Boes, and Ryan Terlecki Rahul DuttaRahul Dutta More articles by this author , Ethan MatzEthan Matz More articles by this author , Nicholas DeebelNicholas Deebel More articles by this author , Elizabeth BoesElizabeth Boes More articles by this author , and Ryan TerleckiRyan Terlecki More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002016.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The prostatic urethral lift (PUL) is a popular surgical option for benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS). Prior 5-year data from the multicenter L.I.F.T. trial suggested durability and a surgical retreatment rate of 13.6%. To determine the rate of definitive correction, we sought to assess the need for ongoing medical or surgical BPH management following PUL. METHODS: With IRB approval, all cases of PUL performed from 2015-2020 at our academic center, notably a participating institution for the L.I.F.T. trial, were retrospectively reviewed. Data extracted included: demographics, medication use, symptomatology, operative details, and surgical reinterventions. RESULTS: 209 men were identified, with follow-up data available for 198 (95%). Mean age was 68.9 years (42–92) and mean follow-up was 18.5 months (0.5–66.4). Mean prostate size was 43.0 grams (8–138). Prior to PUL, significant intravesical protrusion and urethral stricture were noted cystoscopically in 22% and 8% of men, respectively. Mean procedure time was 19 minutes (2–60) and mean number of implants was 5.0 (1–10). Patients were discharged from recovery in 97% of cases, with 29% requiring indwelling or intermittent catheterization. The rate of 30-day complications was 18%, with 89% graded Clavien I or II. Postoperatively, mean improvements in International Prostate Symptom Score (IPSS) and quality of life (QOL) were 5.3 and 1.1 points, respectively. Unplanned emergency room or clinic visits occurred in 14% and 17% of men, respectively, with 4% requiring hospital readmission. Medication for LUTS attributed to BPH (α-blocker or 5α-reductase inhibitor) was continued or initiated postoperatively for 44% of men. 20% of men required repeat surgical intervention at a mean of 19.2 months (1.4–56.4), consisting of repeat PUL (30%), transurethral resection of prostate (28%), or thulium laser enucleation (18%). Overall, 53% of men needed medication and/or repeat surgery for BPH following PUL, and this was independent of age, race, prostate volume, intravesical prostate protrusion, baseline IPSS and QOL, stricture, number of implants used, or a history of urinary retention (p>0.05). CONCLUSIONS: Our data indicate that the majority of men undergoing PUL require ongoing medical and/or surgical management for BPH. Patients should be counseled as to the likelihood of failure as a unimodal therapy long-term. As this does not appear related to patient selection, the overall value of PUL to men with LUTS attributed to BPH should be carefully assessed. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e421-e421 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rahul Dutta More articles by this author Ethan Matz More articles by this author Nicholas Deebel More articles by this author Elizabeth Boes More articles by this author Ryan Terlecki More articles by this author Expand All Advertisement Loading ...