ORIGINAL RESEARCH—SURGERY

Treatment of LUTS Secondary to BPH While Preserving Sexual Function: Randomized Controlled Study of Prostatic Urethral Lift

Corresponding Author

Kevin T. McVary MD

Southern Illinois University, Springfield, IL, USA

Corresponding Author: Kevin McVary, Surgery/Urology, Southern Illinois University School of Medicine, St. John's Pavilion, 301 North Eighth Street, PO Box 19665, Springfield, IL 62794-9665, USA. Tel: 217-545-8860; Fax: 217-545-7305; E-mail: [email protected]Search for more papers by this author

Steven N. Gange MD,

Steven N. Gange MD

Western Urological Clinic, Salt Lake City, UT, USA

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Neal D. Shore MD,

Neal D. Shore MD

Carolina Urological Research Center, Myrtle Beach, SC, USA

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Damien M. Bolton MD,

Damien M. Bolton MD

The Austin Hospital, Melbourne, Vic., Australia

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Barrett E. Cowan MD,

Barrett E. Cowan MD

Urology Associates of Denver, Denver, CO, USA

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B. Thomas Brown MD,

B. Thomas Brown MD

Atlantic Urological Associates, Daytona Beach, FL, USA

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Alexis E. Te MD,

Alexis E. Te MD

Weill Cornell Medical Center, New York, NY, USA

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Peter T. Chin MD,

Peter T. Chin MD

Figtree Private Hospital, Figtree, NSW, Australia

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Daniel B. Rukstalis MD,

Daniel B. Rukstalis MD

Wake Forest University, Winston-Salem, NC, USA

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Claus G. Roehrborn MD,

Claus G. Roehrborn MD

The University of Texas Southwestern Medical Center, Dallas, TX, USA

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on behalf of the L.I.F.T. Study Investigators,

L.I.F.T. Study Investigators

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Kevin T. McVary MD,

Corresponding Author

Kevin T. McVary MD

Southern Illinois University, Springfield, IL, USA

Steven N. Gange MD,

Steven N. Gange MD

Western Urological Clinic, Salt Lake City, UT, USA

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Neal D. Shore MD,

Neal D. Shore MD

Carolina Urological Research Center, Myrtle Beach, SC, USA

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Damien M. Bolton MD,

Damien M. Bolton MD

The Austin Hospital, Melbourne, Vic., Australia

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Barrett E. Cowan MD,

Barrett E. Cowan MD

Urology Associates of Denver, Denver, CO, USA

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B. Thomas Brown MD,

B. Thomas Brown MD

Atlantic Urological Associates, Daytona Beach, FL, USA

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Alexis E. Te MD,

Alexis E. Te MD

Weill Cornell Medical Center, New York, NY, USA

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Peter T. Chin MD,

Peter T. Chin MD

Figtree Private Hospital, Figtree, NSW, Australia

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Daniel B. Rukstalis MD,

Daniel B. Rukstalis MD

Wake Forest University, Winston-Salem, NC, USA

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Claus G. Roehrborn MD,

Claus G. Roehrborn MD

The University of Texas Southwestern Medical Center, Dallas, TX, USA

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on behalf of the L.I.F.T. Study Investigators,

L.I.F.T. Study Investigators

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First published: 30 September 2013

https://doi.org/10.1111/jsm.12333

Citations: 7

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Abstract

Introduction

We analyzed data obtained from a randomized controlled blinded study of the prostatic urethral lift (PUL) to evaluate the sexual side effects of this novel treatment.

Aims

We sought to determine whether PUL, when conducted in a randomized study, significantly improved lower urinary tract symptoms (LUTS) and urinary flow rate while preserving sexual function.

Methods

Men ≥50 years with prostates 30–80 cc, International Prostate Symptom Score (IPSS) >12, and peak urinary flow rate (Qmax) ≤12 ml/s were randomized 2:1 between PUL and sham. Sexual activity was not an inclusion criterion. In PUL, permanent transprostatic implants are placed to retract encroaching lateral lobes and open the prostatic fossa. Sham entailed rigid cystoscopy with sounds to mimic PUL and a blinding screen.

Main Outcome Measures

Blinded groups were compared at 3 months and active arm then followed to 12 months for LUTS with IPSS and for sexual function with sexual health inventory for men (SHIM) and Male Sexual Health Questionnaire for Ejaculatory Dysfunction (MSHQ-EjD). Subjects were censored from primary sexual function analysis if they had baseline SHIM < 5 at enrollment. Secondary stratified analysis by erectile dysfunction (ED) severity was conducted.

Results

There was no evidence of degradation in erectile or ejaculatory function after PUL. SHIM and MSHQ-EjD scores were not different from control at 3 months but were modestly improved and statistically different from baseline at 1 year. Ejaculatory bother score was most improved with a 40% improvement over baseline. Twelve-month SHIM was significantly improved from baseline for men entering the study with severe ED, P = 0.016. IPSS and Qmax were significantly superior to both control at 3 months and baseline at 1 year. There was no instance of de novo sustained anejaculation or ED over the course of the study.

Conclusions

The PUL improves LUTS and urinary flow while preserving erectile and ejaculatory function. McVary KT, Gange SN, Shore ND, Bolton DM, Cowan BE, Brown BT, Te AE, Chin PT, Rukstalis DB, and Roehrborn CG on behalf of the L.I.F.T. Study Investigators. Treatment of LUTS secondary to BPH while preserving sexual function: Randomized controlled study of Prostatic Urethral Lift. J Sex Med 2014;11:279–287.

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Citing Literature

Volume11, Issue1

January 2014

Pages 279-287

Treatment of LUTS Secondary to BPH While Preserving Sexual Function: Randomized Controlled Study of Prostatic Urethral Lift

Abstract

Introduction

Aims

Methods

Main Outcome Measures

Results

Conclusions

References

Citing Literature

References

Information

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Treatment of LUTS Secondary to BPH While Preserving Sexual Function: Randomized Controlled Study of Prostatic Urethral Lift

Abstract

Introduction

Aims

Methods

Main Outcome Measures

Results

Conclusions

References

Citing Literature

References

Related

Information