By: Scott Button, Partner at Clarevia Ventures

RiverMark Medical recently announced a $20 million Series D financing led by Andera Partners to develop the FloStent™ System, an investigational device designed to offer a non-surgical, reversible, office-based treatment option for men with lower urinary tract symptoms due to benign prostatic hyperplasia, or BPH. In simple terms, FloStent is designed to help relieve urinary symptoms by keeping the pathway open, without permanently removing or altering tissue.

Clarevia first backed RiverMark with an early stage financing, and recently participated in the company’s latest round. With this important milestone, I wanted to take the opportunity to reflect on RiverMark’s growth, the journey to date, and why our conviction in the company continues to strengthen.  

A Significant Unmet Need in a Large Market

What first stood out to us about RiverMark was the combination of a compelling market opportunity and clear unmet need within the current BPH treatment pathway.

BPH is incredibly common, yet many men struggle to navigate the available treatment options. For patients with lower urinary tract symptoms, the path often begins with medication. But many men either choose not to try medication or discontinue it relatively quickly. From there, the next steps in care can feel like a significant leap. While existing procedural options are often described as “minimally invasive,” from a patient’s perspective they can still feel quite invasive. That disconnect is what made RiverMark so compelling to us from the very beginning. 

The idea of a truly minimally invasive, reversible therapy that could potentially serve as a first-line device option, or as an alternative for patients who do not want to start or remain on medication, was intriguing to us. It addressed a real clinical and patient need, not an abstract market category.

Conviction in the Founder

The other major factor was Dr. Adam Kadlec. We had known Adam since 2018, before he founded RiverMark. He had raised his hand early in his career as someone interested in innovation and entrepreneurship. He was smart, thoughtful, and deeply respected. He had the qualities of someone you felt was destined to build a company someday—it never seemed like a question of if, but when. 

After he founded RiverMark, we followed the company closely for several years. Throughout that time, we were consistently impressed by how quickly Adam learned and evolved. He also surrounded himself with people who could help him avoid the common mistakes.

That included his co-founder, Andy Doraiswamy, a successful repeat entrepreneur/CEO who is well respected in the medtech community. The fact that Andy was willing to partner with Adam spoke volumes. It also reflected on Adam’s self-awareness, he understood what he did not yet know and was intentional  about surrounding himself with the right experience and expertise. 

For a first-time entrepreneur and CEO, Adam’s ability to execute in a capital-efficient manner was very impressive. The company has continued to make meaningful progress, generating encouraging early pilot study data while steadily building an experienced team and advisor network around a significant clinical opportunity. 

A Device Designed From the Physician’s Point of View

At Clarevia, many of the companies we have been most drawn to have been physician-founded. That matters because the starting point is different. RiverMark was not built from an engineering-first perspective looking for a clinical application. It was built from a practitioner’s point of view by someone who understood the day-to-day realities of treating patients with BPH.

Adam is a practicing urologist, which gave him a deeply informed perspective from the start. He understands the procedures, patient conversations, and tradeoffs within today’s treatment pathway, and that insight is reflected in the design of FloStent.

RiverMark also engaged respected urology thought leaders early on, both in the U.S. and internationally, adding important credibility to the program.

Just as importantly, FloStent is designed to fit naturally within the existing urology workflow. It does not require specialized capital equipment and can be delivered using standard tools many physicians already have in their offices today. The vision is a frontline, in-office therapy performed during a routine cystoscopy. An approach that aligns with how care is already delivered and lowers barriers to adoption.

Progress That Reinforced the Opportunity

When we first invested, RiverMark had generated encouraging early data from its multicenter RAPID II study. Since then, the company has published 12+ month results demonstrating strong clinical performance, rapid recovery, and durable treatment effect. More recently, RiverMark announced enrollment of the first patient in its RAPID III pivotal study, designed to evaluate the safety and effectiveness of the FloStent System. 

Starting With BPH, With Broader Potential

Another aspect of RiverMark that appealed to us was the potential of the platform beyond its initial indication. 

The company is starting with BPH, where the unmet need is significant and the clinical pathway is well-defined, but the underlying approach may have broader applications over time. While the BPH opportunity alone is compelling, the broader platform potential adds to our long-term enthusiasm for what the team is building. 

Bringing Clarity to an Unclear Pathway

There is a nice parallel between Clarevia’s own identity and what RiverMark is trying to do for patients.

Many men experiencing BPH symptoms are still early in their treatment journey, managing symptoms they may be reluctant to discuss while navigating a pathway that can feel unclear and limited.

RiverMark is working to bring more clarity and optionality to that experience. The company’s goal is to provide a solution that is simple, reversible, tissue-preserving, and compatible with an office-based workflow. That alignment between the product, the clinical pathway, the physician experience, and the patient need is exactly the kind of company Clarevia wants to support.

We are grateful to have been part of RiverMark’s journey and look forward to supporting Adam and the team as they continue advancing FloStent through this next chapter.

Learn more about RiverMark at rivermarkmedical.com.