此篇文章刊登於日本泌尿科醫學會的官方雜誌，由日本多個醫學中心一起合作研究高齡亞洲人社會針對前列腺尿道拉提（UroLift）治療良性前列腺增生（BPH）術後評估療效與安全性。研究共納入160名患者，平均年齡為75歲，收錄前列腺體積< 100mL的患者，平均前列腺體積為44 mL。78.1%接受全身麻醉、9.4%接受椎管內麻醉、12.5%接受局部麻醉。術後1個月和3個月的IPSS分別降至11.5分和11.0分（術前為21.5分）。QoL分數分別降至2.4分和2.1分（術前為5.1分）。術後1個月和3個月的Qmax分別升至 11.9 mL/s和12.9 mL/s（術前為9.1 mL/s）。術後PVR分別降至47.9 mL和40.1 mL（術前為121 mL）。94.4%的患者在術後3個月內停止了術前的BPH藥物治療。過度活躍膀胱症狀評分（OABSS）在術後1個月和3個月分別下降至4.7和4.3分（術前為6.2 分）。性功能指數（IIEF-5）術後無顯著變化，表明手術對性功能影響有限。16名患者在手術期間繼續使用抗血小板或抗凝藥物，未發現其術後血紅素變化有顯著差異，顯示無顯著的出血。

統計術前有尿滯留患者術後無需導尿管比例：術後第1天為58.1%，第7天為72.1%，第30天為83.7%，第90天為 88.4%。統計術前無尿滯留患者術後無需導尿管比例：術後第1天為94.9%，第7天為 98.3%，第14天為100%。

前列腺體積≥50 mL的患者相較於前列腺體積<30mL與前列腺體積30mL到50mL間的患者，所需要的手術時間更長且需使用更多植入物，1和3個月的IPSS、QoL、Qmax無顯著差異，但PVR和BVE（膀胱排空量）在前列腺體積 ≥50 mL 的組別中術後 3 個月內表現稍差。

結論：前列腺尿道拉提（UroLift）對於術前無論有尿滯留或無尿滯留，在前列腺體積 <100 mL的高齡合併多種疾病患者，在三個月內的追蹤下是一種安全且有效的治療方法，不過仍要注意治療尿滯留或較大的前列腺術後可能有稍差的療效。

Objectives: Prostatic urethral lift (PUL) for benign prostatic hyperplasia has recently been initiated in Asia; therefore, few studies with real-world data have been reported. This study evaluated the efficacy and safety of PUL using Japanese real-world multicenter data.

Methods: Indications for PUL were based on relevant guidelines in Japan. The preoperative patient status, postoperative progress at 1 and 3 months, and perioperative complications were evaluated. Also, we compared preoperative urinary retention and nonurinary retention patients, and prostate volumes <30, 30 to <50, and ≥50 mL.

Results: A total of 160 patients were included in the study. The mean age was 75 years and the mean prostate volume was 44 mL. The International Prostate Symptom Score, quality of life score, maximum flow rate, and postvoid residual volume significantly improved 1 and 3 months postoperatively compared to preoperatively. The catheter-free rates in the preoperative urinary retention group were 58.1%, 72.1%, 83.7%, and 88.4% on postoperative days 1, 7, 30, and 90, respectively. The catheter-free rates in the nonurinary retention group were 94.9%, 98.3%, and 100% on postoperative days 1, 7, and 14, respectively. The group with a prostate volume ≥50 mL had a longer operation time and used significantly more implants; however, no difference was observed in the postoperative urinary status among the three groups.

Conclusions: PUL can be considered a safe and effective procedure for both preoperative urinary retention and nonurinary retention patients with prostate volumes<100 mL in older patients with comorbidities.