Longitudinal Changes in Overactive Bladder Symptoms After Prostatic Urethral Lift for Benign Prostatic Hyperplasia: A Japanese Single‐Center Prospective Study

OBJECTIVES: The impact of the prostatic urethral lift (PUL) on overactive bladder (OAB) symptoms in benign prostatic hyperplasia (BPH) remains insufficiently defined. This study evaluated longitudinal changes in overactive bladder symptom score (OABSS) after PUL and identified clinical factors associated with meaningful improvement. METHODS: This prospective single-center study included 140 men who underwent PUL between May 2022 and April 2025. Symptoms and functional parameters-including International Prostate Symptom Score (IPSS), quality-of-life (QOL) score, uroflowmetry, and OABSS-were assessed at baseline and at 1, 3, and 6 months. OAB was defined as urgency (OABSS Q3 ≥ 2) with total OABSS ≥ 3. Clinically meaningful improvement was defined as a ≥ 3-point reduction in total OABSS. RESULTS: PUL was associated with significant improvement in IPSS, QOL score, Qmax, and PVR at all postoperative time points. Total OABSS decreased from 5.8 to 4.4, 3.9, and 3.7 at 1, 3, and 6 months (p < 0.001), with most improvement observed within 3 months. All OABSS items showed significant postoperative reductions. Patients with preoperative OAB had larger prostate volumes; however, both OAB and non-OAB groups demonstrated postoperative improvement. Clinically meaningful improvement occurred in 45.8%, 55.4%, and 57.8% of patients with preoperative OAB at 1, 3, and 6 months, respectively. Higher baseline OABSS consistently predicted responder status. CONCLUSIONS: PUL was associated with significant and sustained improvement in storage symptoms up to 6 months. Approximately half of men with preoperative OAB achieved clinically meaningful improvement.