Early single centre experience of prostatic urethral lift (PUL) using 4D technique for treatment for symptomatic benign prostatic hyperplasia (BPH).

BAUS ePoster online library. Varma R. Jun 25, 2019; 259591; P9-5
Raghav Varma
Raghav Varma
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PUL, a minimally invasive procedure has been shown to be effective in treatment of BPH with no significant impact on sexual function (EAU guidelines). 4D Urolift is a new technique in implant delivery (P. Chin, Australia) used to maximally widen the prostatic urethra at the bladder neck and with the ability to manage obstructing median lobes.

Materials & Methods
The 4D Urolift technique places four implants at four quadrants of prostate towards the bladder neck; compared to standard PUL approach. Results of patients who underwent 4D UroLift from September 2017 to September 2018 were collected: pre and post-operative International Prostate Symptomatic Score (IPSS + QoL), sexual function (IIEF + MSHQ-EjD) questionnaires and uroflowmetry data. Statistical analysis was completed using paired t-test.


50 patients underwent 4D UroLift with mean age of 66 (50-87). There was 54% reduction in mean IPSS from 22.3 +/- 7.2 to 11.9 +/- 6.9 (p < 0.001). Significant QoL scores improved from 4.6 +/- 1.1 to 2.1 +/- 1.8 (p < 0.001). Improvement in Qmax from 10.1 +/- 2.6 to 14.6 +/- 6.4 mls/sec (p 0.002) was noted. There were no reports of worsening sexual function and retrograde ejaculation. These improvement in results were comparable to previous studies (Graph 1).

Initial results from 4D Urolift has shown good comparable, if not better outcome, with improvement of lower urinary tract symptoms without compromising sexual function. Further larger trials with longer follow up for 4D PUL technique will be useful to confirm these early promising results.

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