What are the advantages of UroLift®?

In his latest article renowned consultant urological surgeon and andrologist Mr Michael Wanis explains the revolutionary new treatment for benign prostatic hyperplasia, UroLift®. Mr Wanis offers insight into the benefits of this treatment, what the procedures entails, and who is a good candidate for it. 

What is UroLift®, and how does it work to treat Benign Prostatic Hyperplasia (BPH)?

UroLift® is a minimally invasive treatment for patients with obstructive urinary symptoms due to benign prostatic hyperplasia (BPH) also known as an enlarged prostate. The benefit of this technique is to relieve symptoms whilst preserving sexual function including erections and ejaculatory function.

It works by using small titanium implants to hold the prostate lobes apart, relieving pressure on the urethra and allowing the urine to flow more freely and the bladder to empty satisfactorily. This is done via a cystoscope which is a small telescope that is inserted into the urethra (water-pipe). The procedure can be carried out under either a short general anaesthetic or local anaesthetic and patients are usually able to go home on the day of surgery without a catheter. It is associated with a quick recovery time and patients can usually return to work after one week.

How long does a UroLift® procedure take, and is it painful?

A UroLift® usually takes under an hour to complete including anaesthetic time. The procedure time varies depending on the size of the prostate gland and the complexity of the case. If it is carried out under local anaesthetic, a nerve block is performed to numb the prostate, and patients may report mild to no discomfort during the procedure.

What are the potential risks and complications associated with UroLift®?

While UroLift® is considered a safe procedure with a low risk of complications there are some potential risks and complications to be aware of:

• Urinary symptoms (transient): After the procedure it is common to experience some mild burning or increased frequency of urination, or mild blood in the urine, which are transient and usually resolve within two weeks. The patient will be given pain relieving medication and sometimes a short course of antibiotics to take home.
• Urinary tract infection: There is a small risk of developing a urinary tract infection after the procedure, although this is uncommon and usually resolves with antibiotics.
• Urinary retention: occasionally, the UroLift® implants may cause temporary urinary retention, which can be managed with a temporary catheter.
• Need for re-treatment: about 1 in 8 men will have some unresolved symptoms and require further treatment either in the form of medication or another procedure at 5 years.
• Device-related complications (rare): rarely, the UroLift® implants may become dislodged or migrate, and this can usually be corrected with further treatment.

How effective is UroLift® compared to other BPH treatments like medication or surgery?

UroLift® is an effective treatment for BPH in carefully selected patients. Several studies have shown that it can provide significant relief from symptoms and improve quality of life for many patients whilst preserving continence and sexual function.

Compared to medications used to treat BPH, UroLift® has been shown to provide more significant and longer-lasting symptom relief with fewer side effects. Medications such as alpha-blockers (e.g. tamsulosin and alfuzosin) typically work by relaxing the muscles around the bladder neck and prostate to improve urine flow, but they may cause side effects such as dizziness, headache, or sexual dysfunction.

In comparison to traditional surgery such as transurethral resection of the prostate (TURP), UroLift® is a less invasive option with a lower risk of complications and a quicker recovery time. While TURP is effective at relieving symptoms of BPH, it is associated with a longer hospital stay, a higher risk of bleeding, and a longer recovery period. Overall, UroLift® may be a good option for patients with moderate to severe symptoms of BPH who are looking for a minimally invasive treatment with a low risk of complications and a quick recovery time. It is important that patients carefully discuss the different options available with a urologist and the choice of treatment should be based on the individual needs and preferences of the patient.

In my practice, I sometimes use a patient decision aid to help my patients decide on which treatment suits them best.

Who is a good candidate for UroLift®, and who might not be suitable for this procedure?

UroLift® is a suitable treatment option for many men with symptoms of BPH. However, not all patients are good candidates for this procedure.

I typically assess all my patients who are considering UroLift® in the clinic with a uroflow (to objectively measure the strength of their flow), flexible cystoscopy (to assess the prostate anatomy and bladder neck), a prostate volume measurement (using trans rectal ultrasound). Good candidates for UroLift® typically have:

• Moderate to severe symptoms of BPH, such as urinary frequency, urgency, weak stream, and incomplete emptying of the bladder.
• A prostate gland size of less than 80 grams.
• A prostate with obstructing lateral lobes without a large middle lobe or high bladder neck
• A desire to avoid or reduce the use of medications for BPH.
• A desire for a minimally invasive procedure with a quick recovery time.

On the other hand, patients who may not be suitable for UroLift® include those who have:

• A very large prostate gland size (greater than 80 grams) or prostate cancer.
• A history of prostate surgery or radiation therapy.
• A history of urethral stricture or other urethral abnormalities.
• A history of bladder or urinary tract surgery.
• A history of blood clotting disorders or taking blood-thinning medications (these need to be stopped temporarily prior to the procedure).

Mr Michael Wanis is a leading consultant urological surgeon and andrologist based in Ashtead and Horley, with over a decade of experience. If you would like to book a consultation with Mr Wanis you can do so today via his Top Doctors profile.