A new study reviewing recent literature on the prostatic urethral lift suggests the procedure is a safe and lower cost “new paradigm” for the early treatment of symptomatic benign prostatic hyperplasia (BPH). The study, entitled “Prostatic urethral lift: a novel approach for managing symptomatic BPH in the aging man,” was published in The Canadian Journal of Urology.
Great improvements have been made in the clinical management of BPH, but many men still need surgical intervention for indications like progressive voiding or bladder dysfunction. Transurethral resection of the prostate (TURP) is the main surgical approach for such lower urinary tract symptoms (LUTS) as a consequence of BPH. However, TURP can lead to sexual dysfunction and incontinence, and can have a lengthy recovery period.
The Prostatic Urethral Lift (PUL) represents a new endoscopic approach. In this minimally invasive procedure, small permanent intra-prostatic implants are inserted to correct bladder outlet obstruction without affecting tissue integrity. As such, PUL preserves bladder function in men with lower urinary tract voiding symptoms, while better avoiding the risk of adverse effects that an invasive surgical procedure carries.
The review noted that multiple studies of PUL have confirmed improved symptom scores of at least 52% and durability three years out. A randomized multinational study also compared PUL and TURP, establishing PUL’s superiority in terms of symptom relief, quality of recovery, erectile function preservation, ejaculatory function preservation, continence preservation, and safety. According to the U.K. National Institute for Health and Care Excellence, PUL is less expensive than TURP, and earlier PUL treatment may reduce total expenses in patients managed with medication.
As populations age, the number of men diagnosed with BHP will continue to increase, and most will be treated with pharmacological drugs. However, there will be a considerable number needing surgical intervention to overcome serious bladder dysfunction. In these cases, the review concludes, prostatic urethral lift may be a suitable strategy with fewer side effects and lower treatment costs, therefore representing “a safe and cost effective new paradigm for the early therapy for BPH/ LUTS.”