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EAU 2018: BPH related bladder outlet obstruction treatment with MediTate® temporary implantable nitinol device (TIND): 3 years follow up results

Copenhagen, Denmark (UroToday.com) The mechanism for lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH) is suggested to be due to constriction of the prostatic urethra and bladder neck. Recently, a temporary implantable nitinol device (TIND) has been suggested to be efficacious in reshaping the prostatic urethra and reducing the urinary flow obstruction caused by prostatic tissue. Previous reports from this group have presented promising 1-year results, but the durability of symptom relief has not been assessed in long-term follow-up.

Dr. Porpiglia from San Luigi Gonzaga Hospital Department of Urology in Orbassano, Italy presented a prospective cohort study of 32 patients undergoing TIND implantation via cystoscopy for the treatment of LUTS. Patient outcomes were measured at 12, 24, and 36 months post-procedure, primarily via complications on the Clavien-Dindo system, functional results, and quality of life.

Of the 32 patients included in this study, all implantations were successfully performed with no intraoperative complications. The mean age of the cohort was 69.4 years and patients had a mean prostate volume of 29.5 mL, a median IPSS score of 19, and median quality of life of 3. Improvements in IPSS score and quality of life were durable through the 24 month and 36 month follow-up (24 month: 10 IPSS and 2 QoL vs. 12 IPSS and 2 QoL). After three years, the mean increase in qmax remained +71% and the small differences in IPSS and quality of life were not statistically different between the follow-up time periods, showing a durability of response.

Overall, only one patient required TURP as a secondary intervention (as previously reported at 1 year follow-up). As such, the authors recommend the TIND implant as a safe and feasible option for the treatment of BPH-related LUTS. In addition to the group’s promising one-year follow-up results, this study and update has confirmed the durability and efficacy of this procedure with 3 years follow-up. While future studies with a larger patient cohort are recommended, the TIND appears to be a promising intervention for patients with LUTS and a worthy alternative to the TURP.

Authors: Porpiglia F., Amparore D., Bertolo R., Mele F., Garrou D., Checcucci E., Giordano A., Cossu M., Poggio M., Toso S., Scarpa R.M., Fiori C.

Written by: Linda M. Huynh, B.S., University of California-Irvine, at the 2018 European Association of Urology Meeting EAU18, 16-20 March, 2018 Copenhagen, Denmark