The Four-Bladder Neck Implant Technique on Early Outcomes After Prostatic Urethral Lift: A Japanese Prospective Single-Center Study.

OBJECTIVES

Outcomes after prostatic urethral lift (PUL) may vary depending on implant position and bladder neck remodeling strategy. We evaluated the impact of bladder-neck-focused implant density using a four-bladder neck implant technique on early postoperative urinary outcomes.

METHODS

In this prospective study, 220 consecutive patients undergoing PUL were analyzed. Patients were divided into a conventional technique group (n = 110) and a four-bladder neck implant technique group (n = 110). The primary outcome was postoperative transient urinary retention within 30 days after PUL.

RESULTS

Baseline characteristics were generally comparable between groups. Postoperative transient urinary retention occurred significantly less frequently in the four-bladder neck implant group than in the conventional group (13.6% vs. 25.5%, p = 0.026). IPSS was significantly lower at 1 month (9.9 vs. 11.9, p = 0.009) and 3 months (9.4 vs. 11.7, p = 0.007) and Qmax was significantly higher at 1 month (14.6 vs. 12.7 mL/s, p = 0.039) and 3 months (14.7 vs. 12.8 mL/s, p = 0.034) in the four-bladder neck implant group than in the conventional group. In multivariable analysis, the four-bladder neck implant technique was independently associated with a reduced risk of postoperative urinary retention, whereas implant number was not.

CONCLUSION

The four-bladder neck implant technique was associated with improved early outcomes and a lower incidence of postoperative urinary retention. Implant distribution, particularly bladder-neck-focused density, may represent a key determinant of early outcomes after PUL.