📃 Paper Title: Prostatic Urethral Lift (PUL) for obstructive median lobes: 12 month results of the MedLift Study
🧍 Author: Rukstalis
🕒 Year: 2019
📚 Journal: Journal of Endourology
🌎 Country: USA
ㅤContext to the study:
Can you tell be about a study that discusses the benefits of PUL?
ㅤ✅ Take-home message of study:
The sudy shows that the Prostatic Urethral Lift (PUL) procedure is safe and effective for treating lower urinary tract symptoms caused by an enlarged middle/median lobe of the prostate.
Patients experienced significant improvement in symptoms, quality of life and maximum urine flow, with no serious complications or adverse effects on sexual function.
The implant system is a promising treatment option for men with enlarged median lobes of the prostate who want to avoid more invasive surgery.
ㅤ Prospective
Non-randomised
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Study participants:
Participants:
45 Patients
Inclusion criteria:
50 years, IPSS13, Qmax12mLs/s, prostate volume 30-80ml on transrectal ultrasound and an obstructive median lobe defined as 'excessive posterior tissue that during the pre-treatment cystoscopy the operator thought would preclude a normal lateral lobe procedure (including ball valve, high bladder neck, median bar, and hypertrophied central zone)
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Key study outcomes:
The study met both the effectiveness and safety primary endpoints.
Mean IPSS improvement at 1, 3, 6, and 12 months was at least 13.5 points and significantly better than baseline at every time point. QoL and BPHII were similarly improved (>60% and >70%, respectively at 3, 6, and 12 months).
The observed rate of post-procedure device related serious complications was 0%, thereby achieving the primary safety composite endpoint.
Sexual function was preserved with no PUL subjects reporting de novo sustained ejaculatory or erectile dysfunction.
At one-year follow up, no subject had been lost to follow up or exited the study.
One subject required urolift re-treatment.
No subject required BPH LUTS medications for the return of symptoms
Symptom improvement for OML subjects was at least as great as that for Lateral Lobe (LL) subjects from the LIFT study at every time point.
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Study Limitations:
Non-randomized design
Subjective inclusion criteria relating to the median lobe anatomy
71 were screened and 45 were included. The reasons for non-inclusion were not reported and there is a risk of selection bias.
Use of historical controls (L.I.F.T. participants)
Limited long term follow up
Significant differences between the Obstructive Middle Lobe (OML) and Lateral Lobe (LL) only subjects in terms of age and symptoms at baseline
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