Evidence map›Paper›PMID 42265447›Full record

ArticleProstate cancer and prostatic diseases2026

Zenflow spring system for benign prostatic hyperplasia - 24 month outcomes of the ZEST pilot studies.

Peter Gilling, Peter Chin, Paul Anderson, Kevin Zorn, Edward D Matsumoto, William Lynch, Lewis Chan, Henry Woo, Rodrigo Pérez Becerra, Janelle Brennan and 1 more

3 registry-linked trialsAbstract read
PubMed Publisher
In one paragraph

Article in Prostate cancer and prostatic diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03577236 naunknown statusnot on this map

The Zenflow Spring System EU Safety and Performance Study

TypeinterventionalSponsorZenflow, Inc.Ran2019 to 2024Enrolled50ConditionsBenign Prostatic HyperplasiaArmsZenflow Spring System
NCT03595735 naunknown statusnot on this map

The Zenflow Spring System Safety, Performance and Effectiveness Study (ZEST2)

TypeinterventionalSponsorZenflow, Inc.Ran2018 to 2024Enrolled40ConditionsBenign Prostatic HyperplasiaArmsZenflow Spring System
NCT04309695 naunknown statusnot on this map

The Zenflow Spring System Safety and Performance Study (ZEST CAN)

TypeinterventionalSponsorZenflow, Inc.Ran2021 to 2026Enrolled40ConditionsBenign Prostatic HyperplasiaArmsZenflow Spring System
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Peter GillingDepartment of Urology, Tauranga Hospital, Tauranga, New Zealand.
Peter ChinIllawarra Private Hospital, Wollongong, NSW, Australia.
Paul AndersonDepartment of Urology, The Royal Melbourne Hospital, Melbourne, VIC, Australia.ORCID http://orcid.org/0000-0003-3348-9597
Kevin ZornDepartment of Surgery, University of Montreal Hospital Center, Montreal, QC, Canada.ORCID http://orcid.org/0000-0003-3651-6669
Edward D MatsumotoDivision of Urology, McMaster University, Hamilton, ON, Canada.ORCID http://orcid.org/0009-0004-3120-3406
William LynchSection of Urology, Division of Urology, Department of Urology, St George Medical Centre, Sydney, NSW, Australia.
Lewis ChanDepartment of Urology, Concord Repatriation General Hospital, Sydney, NSW, Australia.
Henry WooDepartment of Urology, Blacktown Hospital, Blacktown, NSW, Australia.
Rodrigo Pérez BecerraHospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca, Mexico.
Janelle BrennanGoldfields Urology, Bendigo, VIC, Australia.
Dean EltermanUniversity Health Network, University of Toronto, Toronto, ON, Canada. dean.elterman@uhn.ca.ORCID http://orcid.org/0000-0003-1507-7783

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBenign Prostatic Hyperplasia (BPH) affects more than half of men over age 50, yet current treatment options are limited to medications that cause bothersome side effects or surgical procedures, including minimally invasive surgical therapies (MIST) that involve piercing, cutting, or burning tissue, often leading to discomfort and recovery concerns. The Zenflow Spring System® provides a tissue-preserving alternative that offers symptom relief with quicker recovery and less procedural discomfort.

methodsThree single-arm, multicenter, prospective pilot studies with similar trial designs were conducted from 2018-2021 across four countries and data were combined to evaluate the feasibility, safety, and effectiveness of the Spring System in relieving symptoms of obstructive BPH. Men ≥ 45 years with moderate-to-severe symptoms (International Prostate Symptom Score (IPSS ) >13), peak urinary flow rate (QMax) between 5 and 15 mL/s, prostate volume between 25 and 80 cc, prostatic urethral length between 25 and 45 mm, and voided volume of at least ≥ 125 mL were enrolled. The primary endpoint was symptom improvement 3 months post-procedure, measured by change in IPSS. Secondary endpoints included IPSS-QoL, and functional improvement measured by Qmax. Follow-up visits occurred through 24 months.

resultsSuccessful implantation of the Spring Implant was achieved in all 72 study participants, with no perioperative serious adverse events. At 3 months, mean change from baseline was -10.71 (95% CI: -12.90, -8.51, p < 0.001) for IPSS, -2.1 (95% CI: -2.61, -1.58, p < 0.001) for IPSS-QoL, and 2.86 (95% CI: 1.68, 4.04, p < 0.001) for Qmax, corresponding to 49%, 47%, and 27% improvements, respectively. These improvements were sustained through 24 months, with 48%, 55%, and 32% improvement relative to baseline in IPSS, IPSS-QoL, and Qmax, respectively.

conclusionsAt 24-months, treatment with the Spring System resulted in immediate, significant, and durable improvements compared with baseline, supporting its role as a minimally invasive, tissue-preserving treatment option for men with lower urinary tract symptoms secondary to BPH.

trial registrationNCT03595735, NCT03577236, NCT04309695.

Identifiers

PMID42265447

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.