Twenty-four months failure rate and functional outcomes comparison after implantable nitinol device (iTIND) and prostatic urethral lift (Urolift): real world multicenter study

Abstract

Background:

In recent years, there has been a growing trend toward minimally-invasive techniques (MISTs) in men presenting symptomatic lower urinary tract symptoms (LUTS). However, direct comparisons between techniques are rare. This work compares 2-year functional outcomes and failure rates after implantable nitinol device (iTIND) and prostatic Urethral lift (Urolift).

Methods:

Data of patients presenting with LUTS with an International Prostatic Symptom Score (IPSS) ⩾10, Qmax < 12 mL/s, and prostate volume < 70 mL were obtained retrospectively from two different referral centers’ databases. Patients with neurogenic bladder, sphincter abnormalities, urethral strictures, post-void residual (PVR) volume > 250 mL, urinary bladder stones, and active urinary tract infections were excluded from the study. Treatment failure was defined as the need for surgical retreatment for LUTS or ejaculatory dysfunction. Postoperative uroflowmetry, PVR, IPSS, ejaculatory function, and retreatment rate were collected at 24 months follow-up.

Results:

A total of 134 cases were collected. iTIND was used in 92 (68.7%) patients and Urolift in 42 (31.3%). Baseline characteristics were similar in both groups; however, Urolift patients were younger, with more significant prostate volumes and median lobe enlargement. No patients developed ejaculatory dysfunctions after the treatment, and the retreatment rate was similar in the two groups (13% vs 11.9% p = 0.8). Urolift demonstrated a shorter length of stay. Uroflowmetry, PVR volume, and symptom scores improved in both groups; iTIND cases showed significantly better symptom score reduction.

Conclusions:

The 24-month failure rate was similar for iTIND and Urolift. Urolift reported a shorter hospitalization. Uroflowmetry and PVR results were comparable in both groups. iTIND cases showed slightly superior improvements in symptom scores; however, the clinical significance of this finding must be confirmed by further studies in correlation with prostate volume and median lobe shape.