The prostatic urethral lift procedure for benign prostatic hyperplasia (BPH) offers patients rapid symptom relief, a better urinary flow rate, and improvements in quality of life that persisted for over two years, according to a study that evaluated the method.
In addition, the study, “24-month durability after crossover to the prostatic urethral lift from randomised, blinded sham,” published in the journal BJU International, demonstrated that the technique preserved sexual function — an important issue for BPH patients.
In contrast to most treatments for prostate enlargement, the prostatic urethral lift does not remove or destroy prostate tissue to improve urinary tract symptoms. Instead, it makes use of implants to separate the lobes of the prostate, relieving the urinary duct from being squeezed by an overly large prostate.
Researchers at Wake Forest Baptist Health in North Carolina, and colleagues in Canada and Australia, conducted a Phase 3 clinical trial (NCT01294150) to study the outcomes of the treatment.
Patients were randomized to receive either UroLift implants or a sham surgical procedure. Since the implants are inserted using only local anesthesia, the sham procedure was adapted to mimic the prostatic urethral lift as closely as possible, and was performed behind a screen.
Participants had to stop any ongoing treatment with anticoagulants, 5 alpha-reductase inhibitors, and alpha-blockers before the procedure. All were followed for three months, and those who received sham, if eligible, were then offered the prostatic urethral lift procedure or another treatment.
The published study focused on the 51 patients who had first undergone sham, and then had a urethral lift. During the 24 months after the urethral lift that they were followed, 8 percent had a transurethral resection of the prostate, and one patient (making up 2 percent of the group) had additional urethral implants.
No patients were taking 5 alpha-reductase inhibitors or alpha-blockers at a 24-month examination. Since some left the study early, the final analysis only included 42 patients.
After two years, the International Prostate Symptom Score (IPSS) had improved by 36% for these patients, quality of life measurements by 40%, the BPH Impact Index (measuring the impact on health) by 54%, and the maximum urinary flow rate by 77 percent.
Side effects linked with the procedure were most often mild or moderate, and often resolved after two weeks. However, 4 percent of the devices were found to be misplaced, and were later removed. Researchers noted that in the affected patients, symptoms were stable or improved after the misplaced implants were removed.