madman
Super Moderator
Abstract Context: Lower urinary tract symptoms (LUTS) are one of the most common benign conditions affecting aging men. Among surgical procedures, minimally invasive treatment options have emerged with the main objective to be at least equally effective as current standard techniques, but with a more favorable safety profile.
Objective: To present the technical principle for prostatic urethral lift (PUL) and review clinical outcomes. Evidence acquisition: Medline, PubMed, the Cochrane database, and Embase were screened for randomized controlled trials, clinical trials, and reviews on PUL.
Evidence synthesis: Data from the L.I.F.T study proved that PUL can provide rapid and durable relief of LUTS without compromising sexual function. The BPH6 trial compared PUL with transurethral resection of the prostate (TURP), and its outcomes indicated that improvement of LUTS was more pronounced after TURP, whereas PUL was superior in terms of quality of recovery, ejaculatory function, and quality of sleep.
Conclusions: PUL is an attractive option for selected patients who seek rapid and durable relief of LUTS with complete preservation of sexual function and fast recovery after the intervention.
Patient summary: Prostatic urethral lift is an efficient and safe minimally invasive procedure that offers rapid and durable relief of lower urinary tract symptoms without compromising sexual function.
1. Introduction
The renewed interest in minimally invasive treatment options for the management of male lower urinary tract symptoms (LUTS) due to benign prostatic enlargement (BPE) has led to a plethora of innovative techniques including intraprostatic injections, medical devices, new ablative procedures, and prostatic artery embolization [1,2]. The common main objective is to be equally effective as standard techniques, but with a more favorable safety profile. Patients desire a procedure offering rapid and durable relief of LUTS with a fast and smooth return to normal activity. The ejaculatory function is compromised after current standard procedures, which is a great concern for sexually active men facing surgery. A true minimally invasive procedure is supposed to preserve sexual function including both erectile and ejaculatory function. Ideally, it can be performed in the ambulatory setting under local anesthesia. Among the emerging minimally invasive treatment options, the prostatic urethral lift (PUL; Urolift NeotractInc., Pleasanton, CA, USA) has stood the test of critical clinical evaluation, which led to its approval by the US Food and Drug Administration and NICE within 4 yr after introduction. As part of international guideline recommendations, it is about to become the standard of care [3].
4. Conclusions
In the attempt to provide tailored treatments adapted to the individual clinical profile and the demands of each patient, the emergence of minimally invasive treatment options represents an enrichment of the current armamentarium for the management of male LUTS due to BPE. Urologists need to know the pros and cons of novel technologies for proper decision-making. Urolift offers rapid and durable relief of LUTS with complete preservation of sexual function. In selected patients particularly interested in sexual activity and rapid recovery, it may be an attractive option.
Objective: To present the technical principle for prostatic urethral lift (PUL) and review clinical outcomes. Evidence acquisition: Medline, PubMed, the Cochrane database, and Embase were screened for randomized controlled trials, clinical trials, and reviews on PUL.
Evidence synthesis: Data from the L.I.F.T study proved that PUL can provide rapid and durable relief of LUTS without compromising sexual function. The BPH6 trial compared PUL with transurethral resection of the prostate (TURP), and its outcomes indicated that improvement of LUTS was more pronounced after TURP, whereas PUL was superior in terms of quality of recovery, ejaculatory function, and quality of sleep.
Conclusions: PUL is an attractive option for selected patients who seek rapid and durable relief of LUTS with complete preservation of sexual function and fast recovery after the intervention.
Patient summary: Prostatic urethral lift is an efficient and safe minimally invasive procedure that offers rapid and durable relief of lower urinary tract symptoms without compromising sexual function.
1. Introduction
The renewed interest in minimally invasive treatment options for the management of male lower urinary tract symptoms (LUTS) due to benign prostatic enlargement (BPE) has led to a plethora of innovative techniques including intraprostatic injections, medical devices, new ablative procedures, and prostatic artery embolization [1,2]. The common main objective is to be equally effective as standard techniques, but with a more favorable safety profile. Patients desire a procedure offering rapid and durable relief of LUTS with a fast and smooth return to normal activity. The ejaculatory function is compromised after current standard procedures, which is a great concern for sexually active men facing surgery. A true minimally invasive procedure is supposed to preserve sexual function including both erectile and ejaculatory function. Ideally, it can be performed in the ambulatory setting under local anesthesia. Among the emerging minimally invasive treatment options, the prostatic urethral lift (PUL; Urolift NeotractInc., Pleasanton, CA, USA) has stood the test of critical clinical evaluation, which led to its approval by the US Food and Drug Administration and NICE within 4 yr after introduction. As part of international guideline recommendations, it is about to become the standard of care [3].
4. Conclusions
In the attempt to provide tailored treatments adapted to the individual clinical profile and the demands of each patient, the emergence of minimally invasive treatment options represents an enrichment of the current armamentarium for the management of male LUTS due to BPE. Urologists need to know the pros and cons of novel technologies for proper decision-making. Urolift offers rapid and durable relief of LUTS with complete preservation of sexual function. In selected patients particularly interested in sexual activity and rapid recovery, it may be an attractive option.
