Functional outcomes and retreatment rates after iTIND implantation in a real-world Italian multicenter cohort: the importance of patient selection.

BACKGROUND/

OBJECTIVES

Lower urinary tract symptoms (LUTS) secondary to benign prostatic obstruction (BPO) are common in aging men and impair quality of life. The temporary implantable nitinol device (iTIND) is a minimally invasive surgical treatment intended to improve symptoms while preserving sexual and ejaculatory function. We assessed functional outcomes, retreatment rates, and predictors of retreatment after iTIND implantation in a real-world Italian multicenter cohort.

METHODS

We retrospectively analyzed prospectively collected data from 138 consecutive patients treated with iTIND at seven Italian institutions between January 2022 and May 2025. Follow-up was updated in March 2026 through outpatient visits or structured telephone interviews. Outcomes included IPSS, QoL, Qmax, PVR, IIEF-5, ejaculation preservation, pharmacological and surgical retreatment. Predictors of retreatment were evaluated using Cox regression and Kaplan-Meier analyses.

RESULTS

Median age was 52 years and median prostate volume was 30 mL. All procedures were completed successfully. QoL, IPSS, Qmax, and PVR significantly improved versus baseline at both follow-ups (adjusted p < 0.001). Between follow-ups, only Qmax slightly declined (adjusted p = 0.017), while other outcomes remained stable. Erectile function was unchanged, and antegrade ejaculation was mostly preserved. Adverse events were mild and self-limited. At 1 and 2 years, pharmacological retreatment rates were 21.7% and 37.7%, while surgical retreatment rates were 11.6% and 16.7%. Higher baseline IPSS, lower Qmax, and worse QoL predicted surgical retreatment.

CONCLUSIONS

iTIND provides meaningful symptom improvement with sexual function preservation, but retreatment rates are clinically relevant. Careful patient selection is essential.