Functional outcomes and retreatment rates after iTIND implantation in a real-world Italian multicenter cohort: the importance of patient selection.

BACKGROUND/OBJECTIVES: Lower urinary tract symptoms (LUTS) secondary to benign prostatic obstruction (BPO) are common in aging men and impair quality of life. The temporary implantable nitinol device (iTIND) is a minimally invasive surgical treatment intended to improve symptoms while preserving sexual and ejaculatory function. We assessed functional outcomes, retreatment rates, and predictors of retreatment after iTIND implantation in a real-world Italian multicenter cohort. METHODS: We retrospectively analyzed prospectively collected data from 138 consecutive patients treated with iTIND at seven Italian institutions between January 2022 and May 2025. Follow-up was updated in March 2026 through outpatient visits or structured telephone interviews. Outcomes included IPSS, QoL, Qmax, PVR, IIEF-5, ejaculation preservation, pharmacological and surgical retreatment. Predictors of retreatment were evaluated using Cox regression and Kaplan-Meier analyses. RESULTS: Median age was 52 years and median prostate volume was 30 mL. All procedures were completed successfully. QoL, IPSS, Qmax, and PVR significantly improved versus baseline at both follow-ups (adjusted p < 0.001). Between follow-ups, only Qmax slightly declined (adjusted p = 0.017), while other outcomes remained stable. Erectile function was unchanged, and antegrade ejaculation was mostly preserved. Adverse events were mild and self-limited. At 1 and 2 years, pharmacological retreatment rates were 21.7% and 37.7%, while surgical retreatment rates were 11.6% and 16.7%. Higher baseline IPSS, lower Qmax, and worse QoL predicted surgical retreatment. CONCLUSIONS: iTIND provides meaningful symptom improvement with sexual function preservation, but retreatment rates are clinically relevant. Careful patient selection is essential.