The aim of the study was to evaluate the feasibility and safety of combining prostatic urethral lift (PUL) and a limited resection of the prostatic middle lobe or bladder neck incision in the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH).
Twenty-eight patients were treated at two tertiary centers and followed prospectively. Patient evaluations included patient characteristics, relief of LUTS symptoms, erectile and ejaculatory function, continence, operative time and adverse events. Patients were followed for a mean of 10.9 months.
Patient characteristics were as follows: age 66 years (46-85), prostate volume 39.6 cc (22-66), preoperative IPSS/AUASI 20 (6-35)/QoL 3.9 (1-6)/peak flow 10.5 mL/s (4.0-19)/post-void residual volume (PVR) 123 mL (0-500). Mean operating time was 31 min (9-55). Postoperative complications were minor except for the surgical retreatment of one patient for blood clot retention (Clavien 3b). One patient required catheterization due to urinary retention. Reduction of symptoms (IPSS - 59.6%), increase in QoL (+ 49.0%), increase in flow (+ 111.5%), and reduction of PVR (- 66.8%) were significant. Antegrade ejaculation was always maintained.
Our data suggest that a combination of PUL and transurethral surgical techniques is feasible, safe, and effective. This approach may be offered to patients with moderate size prostates including those with unfavorable anatomic conditions for PUL. This procedure is still 'minimally invasive' and preserves sexual function. In addition, it may add to a higher functional efficacy compared to PUL alone.
DRKS00008970.
Go Beyond the Abstract and Read a Commentary by the Author
World journal of urology. 2018 Feb 15 [Epub ahead of print]
Martin Schoenthaler, Karl-Dietrich Sievert, Dominik Stefan Schoeb, Arkadiusz Miernik, Thomas Kunit, Simon Hein, Thomas R W Herrmann, Konrad Wilhelm
Clinic of Urology, Faculty of Medicine, Medical Center-University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany., University of Rostock Urology Clinic, Rostock, Germany., Department of Urology, Paracelsus Medical University Salzburg, Salzburg, Austria., Department of Urology, Hannover Medical School, Hannover, Germany., Clinic of Urology, Faculty of Medicine, Medical Center-University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany. .