Introduction: Lower urinary tract symptoms (LUTs) caused by benign prostatic hyperplasia (BPH) in men is one of the most frequently encountered complaints in the urologist's office. Prostatic urethral lift (PUL) has been shown to be an efficacious and a minimally invasive treatment for BPH. There is a paucity of data with salvage PUL in BPH. The aim of the study is to determine the effect of PUL in patients with previously treated BPH and radiation therapy. Methods: A retrospective chart review was performed on 445 patients between 6/2016 to 5/2022 of a single surgeon’s experience with PUL. Patients were subgrouped into those that had previous transurethral resection of prostate (TURP), transurethral needle ablation (TUNA), PUL, or radiation therapy (external beam radiation or brachytherapy). The previously treated groups were then compared to those undergoing primary PUL (no previous treatment for BPH). Patient demographics, international prostate symptom score (IPSS) and quality of life (QOL) were assessed through 24 months. Results: A total of 444 patients were retrospectively reviewed. The previous prostatic urethral lift group consisted of 8 (1.8%) patients, previous TUNA had 12 (2.7%) patients, previous TURP had 15 (3.3%) patients and the previous radiation group had 14 (3.1%) patients of the total cohort. The previous urolift group were older (80.9 years) and had larger prostate volume (69.9 grams). The previous TURP group had the largest post void residual (PVR) at 276.1ml. The decrease in IPSS was seen in all groups that were noninferior to primary PUL (no prior treatment group). There was statistical significance for IPSS for the prior radiation group compared to primary PUL at 18 months (4.97 vs. 3.0). Conclusions: Efficacy of PUL has not been well studied in patients with previous prostatic treatments. Our study is one of the largest single surgeon’s experiences with patients with PUL. We show that repeated PUL in patients that had previous PUL, TUNA, TURP, or radiation can be effective. SOURCE OF Funding: n/a
