Multicenter study of the impact of Urolift® implantation in patients undergoing medical treatment for lower urinary tract symptoms secondary to benign prostatic hyperplasia

Introduction and objectives

UroLift® is a minimally invasive treatment for patients with lower urinary tract symptoms secondary to benign prostatic hyperplasia. The primary objective was to evaluate the impact of UroLift® system treatment on quality of life. Secondary objectives assessed the impact on urinary symptoms and sexual function.

Patients and methods

Patients at 7 Spanish hospitals undergoing pharmacological treatment were offered the choice to continue this treatment or accept surgical intervention. The primary outcome, impact on quality of life, was assessed using the EuroQol-5D-5L questionnaire. Secondary outcomes, including impact on symptoms, erectile function, and ejaculatory function, were evaluated using the IPSS, SHIM-5, and MSHQ-EjD-SF questionnaires, respectively. Outcomes were compared between groups.

Results

91 patients chose UroLift® and 45 continued with pharmacotherapy. At 6 months, a positive impact on quality of life was estimated with UroLift® (0.046; SD: 0.02; p = 0.067), being significant in subgroups of patients aged >65 years (diff.: 0.034), PSA > 2.2 (diff.: 0.108), diabetes mellitus (diff.: 0.023), hypertension (diff.: 0.011) or hypercholesterolemia (diff.: 0.016). The impact on symptomatology was superior with UroLift® (−10.07; SD: 1.65; p < 0.001), being significant in subgroups aged >65 (diff.: 1.37), prostate >40 cc (diff.: 0.74), PSA > 2.2 (diff.: 2.63), and diabetes mellitus (diff.: 1.66), hypertension (diff.: 1.23). Erectile function was not affected (-0.33; SD: 1.99; p = 0.868) while ejaculatory function showed a favorable impact (2.98; SD: 1.26; p = 0.019).

Conclusions

Minimally invasive Urolift® system treatment is associated with a positive impact on quality of life and urinary symptoms without adversely affecting sexual function.