SCOTTSDALE, AZ USA (UroToday.com) - Dr. Claus Roehrborn commenced his lecture by speaking about UroLift®, a newer, minimally-invasive treatment for BPH. He reviewed data from the UroLift® trial for which he was principal investigator. He noted that ideal patients should have prostate sizes of 30-50 grams, PVR < 250 mL, and no significant median lobe. Almost all procedures were done under local anesthesia. Post procedure, one-third of patients needed a catheter for less than a day. The most common adverse events were: dysuria 34% (controls 17%), hematuria 26% (controls 5%), and transient pelvic pain 19% (control 9%). No implants in the prostatic urethra were encrusted on surveillance cystoscopy at 1 year. However, 2% of patients had encrustation in the bladder requiring removal. At 1 year follow up, the mean AUA SI improvement was -11 (controls -5.9), Qmax +4.28 (controls +1.98) Qol -2.2 (controls -1.0). No ejaculatory or erectile dysfunction issues occurred. There was a 5% intervention rate at 1 year. These improvements appeared durable on 2-year follow up.
Dr. Roehrborn discussed other minimally invasive treatments that are in earlier phases of development. Medi-Tate’s Temporary Implantable Nitinol Device (TIND) is placed cystoscopically and is allowed to dwell in the prostatic urethra. It is removed on day 5 with the expectation the prostate lumen will remain open after the device had pushed open the prostatic urethral lumen. Early data shows that most patients experience a greater than 50% improvement in AUA SI and flow rate.
ClearRing® utilizes cystoscopically-deployed rings in the prostatic urethra to improve lumen size. VORTX Rx is a histotripsy high-intensity acoustic energy that fragments and homogenizes prostate tissue. It is a mechanical, non-thermal energy that is under investigation at the University of Michigan.
Procept’s Aquablation™ utilizes a high-pressure water jet applied transurethrally to the prostate. Early data demonstrated a significant improvement in flow rate, post void residual and quality of life.
Presented by Claus Roehrborn, MD at the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU) Winter Meeting - February 24 - 28, 2015 - JW Marriott Camelback Inn Resort & Spa - Scottsdale, AZ USA
Reported for UroToday by Drew Freilich, MD. Dr. Freilich is a graduate of the University of Massachusetts Medical School and completed his urology residency at New York Medical College/Westchester Medical Center. He is currently a fellow in Female Urology, Neurourology and Reconstructive Urology at Medical University of South Carolina. He has authored more than 40 peer-reviewed articles, monographs, abstracts, and book chapters and abstracts. Dr. Freilich is a member of the American Urological Association and the Society for Urodynamics and Female Urology.