Clinical application of the UroLift® prostatic urethral lift in Spain: consensus on the treatment of lower urinary tract symptoms associated with urinary flow obstruction and secondary to benign prostatic hyperplasia (BPH).

Benign prostatic hyperplasia (BPH) is an increasingly common pathology in the adult male. BPH increases after the age of 40-45 years, and its management consumes an enormous amount of resources. The UroLift® System is an approved technology designed to treat lower urinary tract symptoms (LUTS) secondary to BPH and is used to perform the prostatic urethral lift (PUL) procedure. Various urology specialists in Spain with experience in PUL have prepared this consensus document. Endorsed by the Spanish Urology Association, its information is based on the most recent findings. The main objective of this document is to disseminate the consensus recommendations among all professionals treating patients with LUTS/BPH. Both primary care physicians and urologists can assess and offer PUL as an effective, minimally invasive treatment.

Safety and efficacy of intraurethral alprostadil in patients with erectile dysfunction refractory to treatment using phosphodiesterase-5 inhibitors.

INTRODUCTION: Phosphodiesterase-5 inhibitors (PDE5i) are the first choice for treating erectile dysfunction (ED) but are not always effective. The aim of this study was to present our experience in treating patients with ED, refractory to treatment with PDE5i, using intraurethral alprostadil (MUSE). MATERIAL AND METHODS: We conducted a review of 82 patients with ED and no response to PDE5i, from March 2013 to October 2014. Forty-seven patients (57%) had hypertension (AHT), 24 (29%) had diabetes (DM) and 20 (24%) had AHT and DM. Additionally, 19 (23%) had undergone radical prostatic (RP) surgery. The patients were evaluated after the treatment was applied and at 4 weeks using the following validated questionnaires: International Index of Erectile Function (IIEF-5/SHIM), Global Assessment Questionnaire (GAQ), Sexual Encounter Profile (SEP) and Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS). RESULTS: The mean patient age was 60.5 years (40-80), and the mean follow-up was 11.3 months (1-20). Sixty-eight percent of the treated patients responded to MUSE(®) (74% in the AHT group, 65% in the AHT+DM group, 62.5% in the DM group and 58% in the RP group). The mean IIEF-5 score was 11.7±4.7, which increased to 18.6±4.9 after MUSE was administered (P=.027). The mean EDITS score at 4 weeks was 61.6 (6-81.9). The most common adverse effect was urethral burning, which occurred in 24 patients (29%). There were no cases of urinary tract infection, syncope or priapism. CONCLUSIONS: Intraurethral alprostadil is an effective treatment and has a broad safety profile for treating patients with erectile dysfunction refractory to oral treatment with PDE5i.