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Prostatic urethral lift for subjects in urinary retention (PULSAR): 12-Month results of a prospective controlled trial compared with real-world outcomes.
Rochester, Mark; Doherty, Ruth; Page, Toby; Barber, Neil; Kavia, Rajesh; Thiruchelvam, Nikesh; Gange, Steven; Mueller, Thomas; Eure, Gregg; Chin, Peter; Kayes, Oliver.
Afiliación
  • Rochester M; Norfolk and Norwich University Hospital Norwich UK.
  • Doherty R; Norfolk and Norwich University Hospital Norwich UK.
  • Page T; Freeman Hospital Newcastle upon Tyne UK.
  • Barber N; Frimley Park Hospital Frimley UK.
  • Kavia R; Northwick Park Hospital Harrow UK.
  • Thiruchelvam N; Cambridge University Hospitals NHS Foundation Trust Cambridge UK.
  • Gange S; Summit Urology Group Murray Utah USA.
  • Mueller T; Delaware Valley Urology Voorhees New Jersey USA.
  • Eure G; Urology of Virginia Virginia Beach Virginia USA.
  • Chin P; South Coast Urology Wollongong New South Wales Australia.
  • Kayes O; Leeds Teaching Hospitals and University of Leeds Leeds UK.
BJUI Compass ; 5(1): 60-69, 2024 Jan.
Article en En | MEDLINE | ID: mdl-38179018
ABSTRACT

Objective:

To examine the safety and efficacy of prostatic urethral lift (PUL) in acute urinary retention (AUR) patients within a controlled (PULSAR) and real-world setting (Real-World Retrospective study). Materials and

methods:

PULSAR was a 12-month prospective study of PUL in AUR patients (n = 51) performed at six centres in the United Kingdom; enrolled BPH patients aged ≥50 years, with prostate volume of ≤100 cc. AUR was defined as being catheter dependent with at least one prior failed trial without catheter (TWOC) while on an alpha-blocker. RWR consisted of 3226 consecutive PUL patients across 22 international sites treated between July 2017 and March 2020; 469 of whom were in urinary retention (RWRr), that is, catheter-dependent at the time of their procedure. Symptom response, uroflow and catheter independence rates were compared between PULSAR and RWRr subjects. A logistical regression model was constructed to evaluate patient baseline and dynamic factors predicting success after the procedure.

Results:

Seventy-three percent of PULSAR subjects were catheter independent and free from surgical reintervention at 12 months post-PUL. Success was associated with higher voiding efficiency during the perioperative period. Slightly higher catheter-independent rates (80%) were seen in RWRr patients; variables that influenced success included age <70 years, lower baseline prostate-specific antigen (PSA), lower baseline post-void residual (PVR) and shorter pre-procedural catheter duration. Logistic regression of the combined PULSAR and RWRr retention groups revealed that procedural age <70 years and higher bladder voiding efficiency (BVE) were associated with success.

Conclusions:

Lower baseline PSA and PVR, younger age and shorter pre-procedure catheter durations drove successful outcomes in AUR patients undergoing PUL. Post-PUL voiding efficiencies may help ascertain long-term response to treatment.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: BJUI Compass Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: BJUI Compass Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos