📃 Paper Title: Prostatic urethral lift vs transurethral resection of the prostate: 2-year results of the BPH6 prospective, multicentre, randomized study
🧍 Author: Christian Gratzke
🕒 Year: 2016
📚 Journal: BJU International
🌎 Country: Germany
ㅤContext to the study:
Can you tell me about a study that compared prostatic urethral lift with transurethral resection of the prostate as options for bladder outflow surgery?
ㅤ✅ Take-home message of study:
In men with symptomatic Benign Prostatic Hyperplasia (BPH), both Prostate Urethral Lift (PUL) and Transurethral Resection of Prostate (TURP) procedures improved lower urinary tract symptoms, quality of life and maximum flow rate (Q max).
TURP was superior for an improvement in IPSS compared to PUL
PUL was superior for quality of recovery, continence in the first 3 months and long term ejaculatory function
ㅤ Prospective, multicentre, randomized control trial
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Study participants:
Number included: 80
Inclusion criteria:
Men over 50 years
Candidate for TURP (symptomatic BPH)
IPSS > 12
Qmax <15 mls/s
Prostate volume <60 cc on ultrasonography
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Key study outcomes:
This study provides 2 year outcome data from a head to head comparison of PUL v TURP that can inform patient counseling regarding these two forms of bladder outflow surgery.
The primary outcome was 'BPH6' a composite of six validated instruments: International Prostate Symptom Severity Score (IPSS), Sexual Health Inventory for Men (SHIM), Male Sexual Health Questionnaire for Ejaculatory Dysfunction (MSHQ-EjD), Incontinence Severity Index (ISI), Quality of Recovery Visual Analogue Score (QoR VAS) and Clavien-Dindo classification of adverse events.
Both TURP and PUL significantly improved LUTS and quality of life compared to baseline.
Change in IPSS score from baseline was significantly superior with TURP v PUL (-15.4 v -10.9 at 12 months, and 15.3 v -9.2 at 24 months).
Quality of recovery was superior for PUL v TURP with 82% v 53% reaching a score of at least 70 on the QoR VAS scale (0-100) at 1 month. Incontinence severity index score was significantly changed from baseline in the TURP arm at 2 weeks and 3 months, but not PUL arms. Ejaculatory function was superior with PUL than TURP, with 100% of PUL patients with preserved function and 34% of the TURP arm unable to ejaculate at 2 years.
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Study Limitations:
Small cohort size (80)
Non-blinded study
Potential conflict of interest with several authors disclosing funding from NeoTract Inc, a manufacturer selling UroLift equipment.
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