Prostatic Urethral Lift

Excerpt

Prostatic urethral lift (PUL) is a minimally invasive procedure approved by the United States Food and Drug Administration for the amelioration of benign prostatic hyperplasia (BPH) symptoms. PUL utilizes implantable medical devices to retract enlarged prostate tissue mechanically, thereby unobstructing the urethra and enhancing urinary flow. The procedure is devoid of tissue heating, excision, or destruction. PUL can also be conducted in a single session under local anesthesia, with the potential to promptly alleviate BPH symptoms and reduce the dependence on chronic BPH medication.

BPH is characterized by a histopathological condition that quantifiably increases the number of stromal and epithelial cells within the prostate. Cellular proliferation leads to a progressive narrowing of the prostatic urethra, culminating in the manifestation of lower urinary tract symptoms (LUTS). These symptoms encompass urgency, increased frequency of urination, nocturnal polyuria, impaired bladder evacuation, initial urinary hesitation, discontinuous urine flow, and a reduced force of the urinary stream.

Epidemiological data indicates that BPH-induced LUTS significantly impinges upon 50% to 75% of men advancing beyond the fifth decade of life, and prevalence escalates to 80% to 90% in the demographic exceeding age 70. Although BPH-induced LUTS predominantly diminishes life quality, its morbidity spectrum extends to recurrent urinary tract infections, acute urinary retention, bladder stones, and hematuria. Standard interventions for BPH-related symptoms involve surgical modalities such as transurethral resection or laser enucleation of the prostate, alongside pharmacological management through sustained oral medication regimens. PUL provides a minimally invasive option in the arsenal of therapeutic modalities.