[Are the UroLift(®) implants an alternative for the treatment of benign prostatic hyperplasia? Short-term results and predictive factors of failure]. / La pose d'implants intra-prostatiques UroLift(®) est-elle une alternative chez les patients ayant une hyperplasie bénigne de la prostate ? Résultats initiaux et facteurs prédictifs d'échec.

ABSTRACT

OBJECTIVE: To report the results of UroLift(®) implants after a 2-year experience in the technique. PATIENTS AND METHODS: The procedure was proposed between February 2012 and April 2014 in patients with symptomatic benign prostatic hyperplasia, as an alternative to standard endoscopic ablation techniques. Evaluation of BPH related symptoms relied on the IPSS and IPSS-QoL self-questionnaires, as well as on maximum uroflow (Qmax). Evaluation of erectile and ejaculatory functions relied on the IIEF5 and MSHQ-EjD self-questionnaires, respectively. RESULTS: A total of 23 patients were treated during this period. Median age was 66 years [53-78]. Median prostate volume was 38mL [20-80]. Preoperative IPSS and IPSS-QoL were 20 [9-29] and 5 [3-6], respectively. No severe adverse event was observed postoperatively. Median follow-up was 14 [5-31] months. At the end of follow-up, 19 (83%) patients reported sustained symptomatic improvement without any additional treatment. Median IPSS and IPSS-QoL were improved significantly (11 [1-27] and 2 [0-6], P<0.0001), with however no significant improvement in Qmax. Four patients needed additional treatment during the first postoperative year. Among them, 3 had a prostate volume>60mL. No patient reported retrograde ejaculation or worsened erectile function. CONCLUSIONS: UroLift(®) implants allowed symptomatic improvement in more than 80% of the patients after 1-year follow-up. A high prostate volume may potentially be predictive of symptomatic failure. LEVEL OF PROOF 5.