Safety and Efficacy of Prostatic Urethral Lift for Lower Urinary Tract Symptoms in Men With a History of Prostate Radiation.

OBJECTIVE

To assess the efficacy of the prostatic urethral lift (PUL) procedure for treating lower urinary tract symptoms (LUTS) in men with a history of prostate irradiation.

METHODS

A retrospective review was performed on patients who underwent PUL following radiation therapy between November 2019 and November 2025. Preoperative and postoperative patient-reported symptom scores, uroflowmetry, post-void residual (PVR), catheter utilization, and need for lower urinary tract symptoms (LUTS) medications were compared to assess the efficacy of the procedure in this cohort.

RESULTS

A total of 41 patients were included in the analysis. The proportion of patients requiring catheterization declined from 51.2% preoperatively to 23.1% at 1 year postoperatively (P = .002). The mean International Prostate Symptom Score (IPSS) improved from 17.8 preoperatively to 12.9 at 1-year follow-up (P = .028). The mean IPSS Quality of Life score improved from 4.5 preoperatively to 2.7 at 1-year follow-up (P<.001). PVR decreased from a mean of 215.9 mL preoperatively to 126.0 mL at 1 year (P = .093). The procedure did not significantly lower the need for LUTS medications (P = .867).

CONCLUSION

The PUL procedure may offer durable symptomatic benefit and improved urinary function in carefully selected patients with a history of prostate irradiation.