The UroLift® System for lower urinary tract obstruction: patient selection for optimum clinical outcome

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Introduction The minimally invasive UroLift® System procedure in moderate-to-severe benign prostate hyperplasia (BPH) refractory to medical treatment may be superior over other prostate procedures regarding its preserved sexual function post-operatively. We aimed to optimise patient selection criteria for the UroLift® System. Material and methods Fifty-one men that underwent UroLift® System surgery were retrospectively reviewed over >24 months. We evaluated the efficacy and safety of UroLift® System, pre-operatively and at three, six, 12, and 24 months post-operatively, assessing the International Prostate Symptom Score (IPPS), urinary flow rates (Qmax), post void residual (PVR) bladder scan volumes and the International Index of Erectile Function (IIEF). Adverse events were assessed by Clavien-Dindo Classification. Results The 51 men undergoing UroLift® System had a success rate of 92.2% over 2 years, with improvements in Qmax, IPSS and PVR. IIEF was preserved in all cases. Adverse events were Clavien-Dindo grade 1, most commonly mild-to-severe dysuria (19.6%), and resolved spontaneously. Four patients failed to improve. Conclusion Patient-related selection criteria to optimise the UroLift® System clinical outcomes include age, Qmax, PVR urine, median lobe, PSA levels, prostate volume, IPSS and IIEF scores. The UroLift® System is safe and effective in moderate-to-severe BPH refractory to pharmacological treatments and avoids retrograde ejaculation.