Journal List > Urogenit Tract Infect > v.14(3) > 1142157

Yang, Shin, Sung, Cho, Kang, Jeong, Choi, Bae, and Kim: Early Experiences of a Minimal Invasive Intra-Prostatic Implant, Prostatic Urethral Lift for Benign Prostatic Hyperplasia Treatment in Korea

Abstract

Purpose

As a minimal invasive device for benign prostatic hyperplasia (BPH) treatment, prostatic urethral lift (PUL) is widely accepted worldwide but not widely used in Korea. We investigated the one-year results of for patients with BPH in Korea.

Materials and Methods

From April 2017 to June 2018, 42 patients with BPH were treated with PUL under local anesthesia with sedation. International Prostate Symptom Score (IPSS) and maximum urinary flow rate and post-void residual (PVR) were evaluated preoperatively and 1, 3, 6, and 12 months later.

Results

Mean age was 69.57±8.58 years old, and mean prostatic volume was 37.17±12.19 cc. Preoperative total IPSS and quality of life (QOL) were 19.94±7.81 and 3.69±1.30, respectively. Total IPSS improved to 11.26±7.22 (p<0.001), and QOL was 2.42±1.43 (p=0.01) after one month. Patients showed no evidence of inflammation related to the implants. IPSS and QOL were somewhat worse after 3 months but were better than baseline at 6 and 12 months. Preoperative maximum flow rate (Qmax) was 9.71±5.45 ml/sec, and one month after surgery, it had improved to 12.63±7.33 (p=0.01); it remained good at 3, 6, and 12 months (12.63±7.38, 12.45±7.39, 14.73±9.67). PVR was not significant at any points postoperative (80.61±67.91 to 43.95±8.19, p=0.119). No patient reported retrograde ejaculation, erectile dysfunction or urinary tract infection.

Conclusions

We evaluated the one-year efficacy of PUL for BPH treatment in Korea, and found significant improvement of IPSS, QOL and Qmax. It is expected that not only the improvement of voiding symptom but also the preservation of sexual function with a low risk of adverse events.

References

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Fig. 1.
Cystoscopic features before (upper) and after (lower) prostatic urethral lift patients.
uti-14-80f1.tif
Fig. 2.
Preoperative, one, three, six, and 12 months results for prostatic urethral lift. (A) Total International Prostate Symptom Score (IPSS), (B) IPSS voiding score, (C) IPSS storage score, (D) maximum flow rate (Qmax).
uti-14-80f2.tif
Table 1.
Subjects' demographics
Demographics Value
Age (y) 69.57±8.58
Number of anchors 2.24 (2–4)
Prostate volume (cc) 37.17±12.19
Prostate specific antigen (ng/ml) 2.11±2.10
Total IPSS 19.94±7.81
IPSS voiding 12.06±5.67
IPSS storage 7.11±3.42
IPSS QOL 3.69±1.30
Qmax (ml/sec) 9.71±5.45
PdetQmax (cm/H2O) 52.34±29.53
BOOI 37.04±29.73
BCI 90.59±35.55
Schäfer grade 2.58±1.30
PVR (ml) 80.61±67.91

Values are presented as mean±standard deviation or average (range). IPSS: International Prostate Symptom Score, QOL: quality of life, Qmax: maximum flow rate, PdetQmax: detrusor pressure at peak flow rate, BOOI: bladder outlet obstruction index, BCI: bladder contractility index, PVR: post-void residual.

Table 2.
Change in the outcomes after prostatic urethral lift: one month to 12 months
Parameter Baseline (n=42) 1 month (n=42) 3 months (n=42) 6 months (n=25) 12 months (n=5)
IPSS 19.94±7.81 11.26±7.22 11.74±7.08 15.38±6.79 13.33±9.02
p-value   <0.001 <0.001 0.001 0.18
IPSS voiding 12.06±5.66 5.71±5.17 6.67±5.34 8.62±4.48 7±6
p-value   <0.001 0.002 0.02 0.126
IPSS storage 7.11±3.42 5.55±2.64 5.07±2.43 6.77±3.00 6.33±3.06
p-value   0.004 0.001 0.03 0.057
IPSS QOL 3.69±1.30 2.42±1.43 2.22±1.37 2.77±1.48 3±1
p-value   0.01 0.64 0.636 0.573
Qmax (ml/sec) 9.71±5.45 12.63±7.33 12.63±7.38 12.45±7.39 14.73±9.67
p-value   0.01 0.002 0.03 0.324
PVR (ml) 80.61±67.91 43.95±8.19 33.23±48.81 31.65±39.71 19.33±17.01
p-value   0.119 0.003 0.206 0.5

Values are presented as mean±standard deviation. IPSS: International Prostate Symptom Score, QOL: quality of life, Qmax: maximum flow rate, PVR: post-void residual. p-value compares clinical differences from baseline.

Table 3.
Overview of adverse events over one year after the prostatic urethral lift
Adverse events 0–1 month 1–3 months 3–6 months 6–12 months
Total available subjects 42 32 18 5
Related adverse events 5 1 0 0
Clavien grade 1        
Dysuria 1 (2.4) 0 0 0
Urinary retention 3 (7.1) 1 (3.1) 0 0
Hematuria 1 (2.4) 0 0 0
Urinary tract infection 0 0 0 0
Erectile dysfunction 0 0 0 0
Retrograde ejaculation 0 0 0 0
Clavien grade 2 0 0 0 0

Values are presented as number only or number (%).

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