Urolift Pre-SBRT for Reduced Urinary Toxicity in Patients With BPH and Prostate Cancer.

Reduction of Urinary Toxicity of Stereotactic Body Radiation Therapy (SBRT) With Prostatic Urethral Lift (Urolift)

Many patients may face long-term urinary side effects following stereotactic body radiation therapy (SBRT), including increased urinary frequency, dysuria, and nocturia. The investigator hypothesizes that Urolift, which represents a novel minimally invasive therapy, may reduce acute and long-term urinary toxicity and side effects of radiation therapy (SBRT).

Urolift is a standard of care treatment for BPH. It involves the placement of a stainless-steel urethral end piece tethered to a capsular tab to the left and right side of the prostatic urethra approximately 1.5cm distal to the bladder neck. It pulls and maintains the opening of a continuous channel through the prostatic urethra. A previous study examined the effect of Urolift on urinary symptoms and urinary medications at six months post-procedure.Urolift was associated with significant urinary improvements measured by IPSS and quality of life questionnaires and a reduction in the use of total medication as well as alpha-blockers and beta-3 agonists.

Inclusion Criteria:

• Subject is 50 - 99 years of age
• Subject has provided informed consent
• Subject has diagnosis of prostate cancer requiring SBRT
• Subject is able to complete self-administered questionnaires
• Subject is a surgical candidate for Urolift
• Subject has a diagnosis of BPH
• Medical record documentation of prostate volume from 30-80 ml by TRUS
• Absence of a middle lobe

Exclusion Criteria:

• Life expectancy < 2 years
• Currently enrolled in or plans to enroll in any concurrent drug or device study
• Concurrent androgen deprivation therapy
• Has an active infection (e.g., urinary tract infection or prostatitis)
• Diagnosis of or has received treatment for chronic prostatitis or chronic pelvic pain syndrome (e.g., nonbacterial chronic prostatitis)
• Subject has been diagnosed with a urethral stricture or bladder neck contracture within the last 180 days
• Subject has been diagnosed with 2 or more urethral strictures and/or bladder neck contractures within 5 years
• Diagnosis of lichen sclerosis
• Neurogenic bladder or other neurologic disorder that affects bladder function
• Diagnosis of polyneuropathy (e.g., diabetic)
• History of lower urinary tract surgery
• Subject has diagnosis of stress urinary incontinence that requires treatment or daily pad or device use
• Subject has been catheterized or has a PVR > 400 ml in the 14 days prior to the surgical procedure
• Current diagnosis of bladder stones