UroLift: minimally invasive treatment for enlarged prostate (BPH)

Benign Prostatic Hyperplasia (BPH), or an enlarged prostate, significantly affects men's health, leading to uncomfortable urinary symptoms.

The UroLift procedure emerges as a minimally invasive surgical option, offering a new lease on life for patients suffering from this condition. This is recognised by European Association of Urology (EAU)and National Institute for Health and Care Excellence (NICE)

What is BPH?

An enlarged prostate gland characterises BPH, which can compress the urethra and obstruct urine flow. This can result in frequent urination, difficulty initiating urine flow, and a weak urine stream, among other symptoms.

What is the UroLift Procedure?

The UroLift system introduces a novel approach by using tiny implantable devices to lift and hold the enlarged prostate tissue. This action clears the urethral passage without needing tissue removal, resulting in immediate symptom relief.

How is UroLift performed?

A urologist performs the UroLift by inserting a unique device into the prostate through the urethra. Tiny implants are then placed to retract the lobes of the prostate, thereby reducing obstruction and improving urine flow.

Is UroLift better than a TURP?

Advantages of UroLift

• Minimally Invasive Nature: With no incisions required, UroLift stands out as less invasive compared to traditional surgeries.
• Rapid Recovery: The recovery period is typically short, with patients returning to their routines within days.
• Sexual Function Preservation: UroLift has a lower risk of compromising sexual function, a concern with other BPH treatments.
• Immediate Symptom Alleviation: Patients often experience prompt improvement in urinary symptoms post-procedure.

What are the side effects of UroLift?

• Postoperative Discomfort: Some patients might encounter pelvic pain or discomfort temporarily after the procedure.
• Infection Risk: Surgical interventions always pose an infection risk, though it is relatively low with UroLift.
• Variable Symptom Relief: There's a possibility that the procedure may not alleviate symptoms for every individual.
• Possibility of Additional Treatments: Over time, some patients may require further interventions to sustain symptom relief.

Who is eligible for UroLift?

What investigations will you be asked to do?

• Medical and Symptom Review: A comprehensive medical history and symptom analysis using the IPSS guide the initial evaluation.
• Physical Examination: A digital rectal exam is conducted to assess prostate size and condition.
• Diagnostic Imaging: Ultrasound or MRI imaging provides detailed visualisation of the prostate's anatomy.
• Cystoscopic Examination: A cystoscope gives a direct view of the urethra and prostate, aiding in the decision-making process.
• Urodynamic Testing: These tests are critical to understanding bladder and urethral function in urine storage and release if the above investigations are unclear.

What can I expect after UroLift?

Immediate Aftercare

Patients might notice urinary discomfort and slight bleeding following the procedure, but these symptoms typically resolve quickly.

First Week Post-Procedure

Patients are advised against heavy physical exertion during the first week, with most resuming normal activities shortly thereafter.

Long-Term Outcomes

Most patients report a significant improvement in life quality, noting better sleep due to reduced nocturnal bathroom visits and enhanced urinary flow.

Will my prostate grow back after UroLift?

The growth of the prostate may persist following the UroLift® System procedure. Nevertheless, having undergone this treatment does not rule out the possibility of future interventions, whether it be an additional UroLift® System procedure, laser therapy (HoLeP), or a Transurethral Resection of the Prostate (TURP).

Are there alternatives to UroLift?

• Medications: These include alpha-blockers and 5-alpha reductase inhibitors.
• TURP: is often considered the standard treatment, yet it's more invasive than UroLift.
• Aquablation: waterjet treatment for the enlarged prostate
• Laser Therapies: Procedures like holmium laser enucleation and GreenLight laser therapy are other options.
• Rezum: a minimally invasive treatment for enlarged prostates that uses water vapour therapy to reduce the size of the prostate and alleviate urinary symptoms.

Is UroLift the best treatment?

• Invasiveness: UroLift is less invasive than TURP and laser therapies.
• Recovery Timeline: UroLift offers a quicker recovery period than other surgeries.
• Sexual Health: There is a lower chance of affecting sexual function with UroLift.
• Efficacy: While medications might have delayed onset and lesser efficacy for severe symptoms, UroLift can provide immediate relief in most cases.

Reflection from a urologist on this minimal invasive treatment

The UroLift procedure presents a promising option for men with BPH, prioritizing a minimally invasive approach with a quick recovery and sustained quality of life.

A thorough evaluation by a urologist is crucial to determining the best course of action tailored to the patient's specific condition and needs.