Elsevier

Urology

Volume 104, June 2017, Pages 230-234
Urology

Surgical Techniques in Urology
UroLift in Place of Fiducial Markers for Patients With Benign Prostatic Hyperplasia Undergoing External Beam Radiation Therapy

https://doi.org/10.1016/j.urology.2016.11.029Get rights and content

Objective

To investigate if using a novel treatment for obstructive benign prostatic hyperplasia (UroLift) to relive lower urinary tract symptoms (LUTS) prior to external beam radiotherapy (EBRT) could also supplant the use of fiducial markers obviating the need for a second transrectal procedure while facilitating symptom-free voiding during and after EBRT a series of patients are reported on.

Methods

The medical records of 7 consecutive patients who underwent placement of UroLift for simultaneous treatment of obstructive LUTS due to benign prostatic hyperplasia and targeting of EBRT for treatment of prostate cancer between September and December of 2015 were reviewed.

Results

The UroLift clips were sufficiently radiopaque to make targeting possible for EBRT. All patients were able to complete a full course of radiotherapy without placement of fiducial markers. No patient experienced complications that could be attributed to the UroLift implants or procedure during their course of radiotherapy. None of the patients required additional alpha-blockers during radiation therapy.

Conclusion

The UroLift system can serve as fiducial markers in patients undergoing EBRT. Although the current clip utilized in the UroLift system is generally radiopaque, it does not project well on the sagittal plane and would be significantly enhanced if a more strongly opaque substance was incorporated. It remains to be proven if the UroLift system can significantly reduce the symptoms of LUTS during and post EBRT.

Section snippets

Patients

The medical records of 7 consecutive patients who underwent placement of UroLift for simultaneous treatment of obstructive LUTS due to BPH and targeting of EBRT for treatment of prostate cancer between September and December of 2015 were reviewed. Patients were considered eligible if they had moderate- to high-risk, localized prostate cancer that would make them typical candidates for EBRT as well as obstructive LUTS due to BPH. For inclusion into this study, patients must have failed medical

Results

Seven consecutive patients were included in this study. The general patient characteristics are shown in Table 1. The average age of patients was 65 years old, and all patients had medical comorbidities. Prior to placement of the UroLift system, all patients were trialed on medical therapy for LUTS for a minimum of 1 month, 3 of whom continued medical therapy after UroLift implantation. Immediately following placement of UroLift, 6 of 7 patients reported significant improvement in their LUTS,

Discussion

The UroLift system is a recently approved non-destructive surgical treatment for obstructive LUTS due to BPH that consists of small implants which pass from within the urethra to the prostatic capsule, compressing the prostate between them.2, 3 Both the intraurethral and extracapsular components of these implants are sufficiently radiopaque to be visible on a normal flat x-ray image. This suggests that in patients with UroLift implants who require EBRT for treatment of prostate cancer, the

Conclusion

In patients with comorbid localized high-risk prostate cancer and BPH with medical therapy-resistant LUTS, the dual use of the UroLift system for treatment of obstructive LUTS and replacement of fiducial markers may save time, cost, and risk. Although the current clip utilized in the UroLift system is generally radiopaque, it does not project well on the sagittal plane and would be significantly enhanced if a more strongly opaque substance was incorporated. It remains to be proven if the

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  • Cited by (0)

    Financial Disclosure: The authors declare that they have no relevant financial interests.

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