Prostatic Urethral Lift (PUL) vs Transurethral Resection of the Prostate (TURP): 2 Year Results of the BPH6 Prospective, Multi-Center, Randomised Study

OBJECTIVES: To compare Prostatic Urethral Lift (PUL) to Transurethral Resection of the Prostate (TURP) with regard to symptoms, recovery experience, sexual function, continence, safety, quality of life, sleep and overall patient perception.

SUBJECTS/PATIENTS AND METHODS: 80 patients with lower urinary tract symptoms due to benign prostatic hyperplasia (BPH) enrolled in a prospective, randomised, controlled, non-blinded study conducted at 10 European centers. The BPH6 responder endpoint assessed symptom relief, quality of recovery, erectile function preservation, ejaculatory function preservation, continence preservation, and safety. Additional evaluations of patient perspective, quality of life, and sleep were prospectively collected, analyzed, and presented here for the first time.

RESULTS: Significant improvements in International prostate symptom score (IPSS), IPSS quality of life (QoL), BPH Impact Index (BPH II), and peak flow rate were observed in both arms through the 2 year follow up. TURP IPSS and peak flow change were superior to PUL. IPSS QoL and BPH II improvements were not statistically different. PUL resulted in superior quality of recovery, ejaculatory function preservation, and performance on the composite BPH6 index. Ejaculatory function bother scores did not demonstrate statistically significant change in either treatment arm. TURP significantly compromised continence function at 2 weeks and 3 months. Only PUL resulted in statistically significant improvement in sleep starting at the 6 month interval and continuing to the end of the study. Over the two year follow up, 6 PUL subjects (13.6%) and 2 TURP subjects (5.7%) underwent secondary treatment for return of LUTS. Most patients perceived LUTS improvement and would recommend their treatment procedure to a friend.

CONCLUSION: PUL was compared to TURP in a randomised, controlled study which further characterized both modalities so that care providers and patients can better understand the net benefit when selecting a treatment option. This article is protected by copyright. All rights reserved.