%0 Journal Article
%T Prostatic Urethral Lift (PUL) for obstructive median lobes: 12 month results of the MedLift Study
%J -
%D 2018
%R https://doi.org/10.1038/s41391-018-0118-x
%X Evidence indicating Prostatic Urethral Lift (PUL) delivers significant improvement in symptomatic BPH with low morbidity is based on subjects with lateral lobe (LL) enlargement only. MedLift was an FDA IDE extension of the L.I.F.T. randomized study designed to examine safety and efficacy of PUL for treatment of obstructive middle lobes (OML). Inclusion criteria for this non-randomized cohort were identical to the L.I.F.T. randomized study, except for requiring an OML:ˋ≡ˋ50 years of age, IPSSˋ≡ˋ13, and Qmaxˋ≒ˋ12ˋml/s. Primary endpoint analysis quantified improvement in IPSS over baseline and rate of post-procedure serious complications. Quantification of symptom relief, quality of life, flow rate, and sexual function occurred through 12 months. Outcomes were compared to historical L.I.F.T LL results and were combined to demonstrate the full effectiveness of PUL. Of the 71 screened subjects, 45 were enrolled. At 1, 3, 6, and 12 months, mean IPSS improved from baseline at least 13.5 points (pˋ<ˋ0.0001). Quality of life and BPHII were similarly improved (>60% and >70%, respectively at 3, 6, and 12 months, pˋ<ˋ0.0001). Mean Qmax improvement ranged from 90 to 129% (pˋ<ˋ0.0001). At 1 month, 86% (CI 73每94%) reported ≡70 on the Quality of Recovery scale, 80% (CI 66每89%) reported being ※much§ or ※very much better,§ and 89% (CI 76每95%) would recommend the procedure. Compared to LL subjects, OML subjects＊ symptoms improved at least as much at every time point (OML range 13.5每15.9, LL range 9.9每11.1, pˋ≒ˋ0.01). On combining OML with LL data, >70% (range CI 63每81%) of subjects demonstratedˋ≡ˋ8 point improvement in IPSS through 12 months. Analysis of the combined dataset indicatesˋ≡ˋ40% (CI 30每51%) of sexually active men improved the minimal clinically important difference in erectile function through 12 months. Prostates, including those with middle lobe obstruction, can be treated with the PUL procedure safely and effectively
%U https://www.nature.com/articles/s41391-018-0118-x