Prostatic urethral lift (pul) is superior to turp in the preservation of ejaculatory function in patients with obstructive median lobes (oml)

Abstract Introduction For the past several years, the AUA has recommended PUL as a treatment option for eligible patients who desire preservation of erectile and ejaculatory function. Objective This analysis serves as the first detailed assessment of sexual function and symptom outcomes among patients treated with PUL, TURP or sham in controlled and real-world studies of PUL. Methods Outcomes including MSHQ bother and ejaculatory function scores were compared for the following groups through 12 months: 66 patients from the L.I.F.T. pivotal RCT with lateral lobe (LL) obstruction randomized to sham, 36 men with LL obstruction in the BPH6 RCT randomized to TURP, and 45 men with OML in MedLift, the FDA-approved IDA extension of the LIFT trial. Patients in the large RWR study were filtered to approximate the MedLift population and results for the 187 OML patients were compared with MedLift. Results OML patients treated with PUL demonstrated superior ejaculatory function and bother scores compared to TURP LL only at all timepoints (Figure 1); at 1- and 3 months, MedLift subjects also experienced significantly better IPSS and QoL improvement post-PUL compared to TURP. IPSS improvement was 170% greater for MedLift subjects than sham LL at 3 months; MedLift subjects experienced significantly better QoL, Qmax, and BPHII improvements over the same time period. IPSS, QoL, Qmax, and PVR outcomes were equivalent for MedLift and RWR OML groups at 3-, 6-, and 12 months post-PUL; overall adverse events were not elevated in the RWR OML group. Conclusions Compared to TURP, PUL provides quicker symptom improvement during the early post-operative period with superior ejaculatory function outcomes through 12 months post-treatment in patients with OML. PUL continues to preserve sexual function for BPH patients despite LL or OML obstruction. Disclosure Yes, this is sponsored by industry/sponsor: Neotract, Inc./Teleflex Clarification Industry initiated, executed and funded study Any of the authors act as a consultant, employee or shareholder of an industry for: Neotract, Inc./Teleflex.