What's New in TIND?

Eur Urol Focus. 2018 Jan;4(1):40-42. doi: 10.1016/j.euf.2018.04.009. Epub 2018 Apr 26.

Abstract

Context: There is growing interest in minimally invasive (MI) treatment options for male lower urinary tract symptoms (LUTS). Among these options, the temporary implantable nitinol device (TIND; Medi-Tate, Or Akiva, Israel) is a novel instrument used to alleviate symptoms by creating incisions in the prostate via mechanical stress.

Objective: To review recent data for TIND as an MI procedure to improve LUTS.

Evidence acquisition: Medline, PubMed, the Cochrane Database, and Embase were screened for clinical trials, randomized controlled trials, and review articles on the use of TIND in patients with male LUTS.

Evidence synthesis: There are currently two studies available, one being a follow-up of the first pilot study. Both 12-mo and 36-mo results suggest at least medium-term effects of TIND in terms of symptom improvement (International Prostate Symptom Score, IPSS) and maximum urinary flow (Qmax). IPSS was improved by 41% after 12mo (p<0.001) and worsened only insignificantly after 36mo compared to baseline values. Qmax increased by 4.4ml/s after 12mo (p<0.001) and did not decrease significantly after 36mo. Postoperative complications were mild and included urinary tract infection and urinary retention.

Conclusions: Preliminary data suggest that TIND is a safe and effective MI technique for patients with male LUTS. Symptom relief and increase in urinary flow after 36mo are promising. However, long-term results are needed.

Patient summary: Various treatment options for male patients suffering from urinary voiding symptoms are emerging. TIND, a temporary implantable nitinol device, appears to be a safe option that improves symptoms without affecting sexuality.

Keywords: Benign prostatic hyperplasia; Male LUTS; Minimally-invasive operation.

Publication types

  • Review

MeSH terms

  • Alloys / adverse effects*
  • Clinical Trials as Topic
  • Humans
  • Israel / epidemiology
  • Lower Urinary Tract Symptoms / diagnosis
  • Lower Urinary Tract Symptoms / psychology
  • Lower Urinary Tract Symptoms / surgery*
  • Male
  • Minimally Invasive Surgical Procedures / methods
  • Postoperative Complications / epidemiology
  • Prostate / pathology
  • Prostate / surgery*
  • Prostatic Hyperplasia / complications
  • Prostatic Hyperplasia / pathology
  • Prostatic Hyperplasia / surgery*
  • Prostheses and Implants / adverse effects
  • Prostheses and Implants / standards*
  • Randomized Controlled Trials as Topic
  • Stress, Mechanical
  • Urinary Retention / complications
  • Urinary Tract Infections / complications

Substances

  • Alloys
  • nitinol