Urolift Minimally Invasive BPH Treatment
One of the newer and more commonly advertised treatments for enlarged prostate, also known as benign prostatic hyperplasia, or BPH is the Urolift procedure. Urolift is a minimally invasive, non-surgical option for relieving lower urinary tract symptoms (LUTS). Urolift is a potentially beneficial option for qualifying patients, which can be discussed during your consultation with Dr. Kapadia. This article will discuss how Urolift works and whether it may be your best option.
How the Urolift Is Placed
Virtually all surgical BPH therapies, whether in the office or in the operating room, involve mechanical removal, laser cutting, or ablation of excess prostatic tissue. However, Urolift is different because it uses implanted sutures to pull the tissue within the prostate away from the urethra and relieve symptoms. These sutures are placed using endoscopy, meaning no surgical incisions are made in the abdomen or pelvis. Instead, the device is inserted via the urethra.
The procedure can be performed in the office but is often done in an outpatient surgery center under local anesthesia and takes approximately 15 minutes. Patients leave the office or surgery center within an hour of treatment. Often, patients do not require a post-operative urinary catheter as is the case for most other BPH procedures.
Other than some continued lower urinary tract symptoms that may persist for up to a month, patients will experience rapid relief of their symptoms, and Urolift has shown to be effective for upwards of five years, though the longevity of the procedure will vary based on the individual. Patients can typically return to normal activity relatively soon (within days) after their procedure with few limitations.
Benefits of Urolift
As stated above, Urolift is a minimally invasive procedure that does not require incisions and often does not require a post-operative urinary catheter. As such, patients can return to their normal lives very quickly and enjoy the procedure’s benefits sooner than most other BPH procedures. It does not affect semen volume, unlike traditional procedures such as TURP. The incidence of retrograde ejaculation, incontinence, and erectile dysfunction is much reduced compared to some surgical options like TURP or GreenLight Laser.
Considerations of Urolift
The most common side effects are usually mild to moderate and include pain or burning sensations during urination, blood in the urine, pelvic pain, urgent need to urinate, and inability to control the urge to urinate. Most of these side effects resolve within two to four weeks after the procedure. Serious bleeding problems are rare but possible.
Some rare but significant potential complications are associated with any implanted foreign body. First, implants are more prone to short- and long-term infection. Second, if the implants were to fail, patients would no longer benefit from Urolift and may need a follow-up corrective procedure. Lastly, there is a small risk of a bleeding event that could ultimately require a visit to the hospital. Some of these risks can be mitigated by employing a highly experienced urologic surgeon such as Dr. Kapadia
Taking a Stepwise Approach
When discussing possible options for treating BPH, it’s important that we take a stepwise approach, starting with lifestyle change and medical therapy to relieve some of the worst lower urinary tract symptoms. From there, minimally invasive in-office procedures may be considered for many patients. Urolift may also be considered for the appropriate patient demographic. Patients with particularly large prostates, those over 100g or so, will likely be referred to surgery or more invasive procedures, such as a simple prostatectomy, HoLEP, or Aquablation, a relatively new robotically managed BPH treatment option that uses waterjets to destroy prostatic tissue.
The Bottom Line
As with the treatment continuum for any disease or condition, we aim to use the least invasive, most effective, and ultimately safest option possible. To that end, Urolift has a place in treating some BPH patients, and we will discuss this and other options during your consultation.
Iqbal M, Jones R, Hughes S, Shergill I. Low power HOLEP after failed urolift: A case report using 50 Watt laser. Urol Case Rep. 2017 Dec 5;16:114-115. doi: 10.1016/j.eucr.2017.11.029. PMID: 29255680; PMCID: PMC5724983.