Urology | 2021
Prostatic Urethral Lift in Patients with Obstructive Median Lobes: A Single Surgeon Experience at an Academic Center.
Abstract
OBJECTIVES\nTo examine the long-term efficacy of Prostatic Urethral Lift (PUL) for treating men, with or without an obstructive median lobe (OML), who suffer from lower urinary tract symptoms (LUTS) attributed to benign prostatic hyperplasia (BPH).\n\n\nMATERIALS AND METHODS\nA retrospective review was performed on all consecutive PUL cases with or without OML from October 2017 to November 2019 by a single academic surgeon. Outcomes were measured using the International Prostate Symptoms Survey (IPSS) with quality of life (QoL) scores. Comparative testing and mixed-effects linear regression analysis were utilized with significance set at α=.05 and performed with Stata (College Station, TX).\n\n\nRESULTS\nA total of 110 PUL procedures were performed on 106 patients (four repeat surgeries) with a median age of 66.5 (interquartile range: 60.4-73.7). Twenty-three patients (21.7%) had an OML. Following PUL, patients in both groups showed significant improvements in IPSS (P<.001) and QoL (P<.001) scores. When stratifying by OML and controlling for confounding, IPSS scores in both groups displayed statistically significant improvement at follow-up visits, with no statistically significant inter-group difference (P=.32). The same held true for QoL improvements, with no statistically significant difference between groups (P=.18). The presence of an OML resulted in minimal effects on perioperative outcomes and complications but required significantly more implants (P=.008).\n\n\nCONCLUSIONS\nPUL is a minimally invasive procedure effective at reducing LUTS and improving the lives of men with BPH without incurring risks of serious complications. These improvements were equivalent and upheld in patients who presented with OML.