LAUSR

PURPOSE The surgical reintervention rate after prostatic urethral lift (PUL) is not well characterized, but has been estimated at 2-3%/yr. We performed a systematic review and meta-analysis to determine the surgical reintervention rate after PUL. MATERIALS AND METHODS We systematically searched Medline, Embase, and the Cochrane Central Register of Controlled Trials for studies of men treated with PUL reporting at least 1 year of maximum follow-up data. We performed a random effects meta-analysis to estimate the annual rate of surgical reintervention after PUL, including those performed for lower urinary tract symptoms (LUTS) or involving device explant, additions, or replacement. The robustness of the meta-analysis conclusions was evaluated in a one-study removed analysis and heterogeneity was investigated with a subgroup analysis. RESULTS In 11 studies (2,016 patients), 153 surgical reinterventions were performed, among which transurethral resection of the prostate/laser (51.0%), repeat PUL (32.7%), and device explant (19.6%) were most common. The annual rate of surgical reintervention was 6.0%/yr (95% CI: 3.0%-8.9%). These results were not significantly influenced by any single study. The annual rate of surgical intervention was significantly influenced by the mean duration of patient follow-up. Surgical reintervention rates were 4.3%/yr in studies with ≤1 year mean follow-up, 10.7%/yr in studies with >1 year to 3 years mean follow-up, and 5.8%/yr in a single study with >3 years mean follow-up (p=0.04). CONCLUSIONS The surgical reintervention rate with PUL is 6.0%/yr and is higher in studies with longer follow-up durations.