Urolift Minimally Invasive BPH Treatment

Until relatively recently, patients with an enlarged prostate, also known as BPH or benign prostatic hyperplasia, had comparatively few treatment options. While very effective, TURP, for example, requires anesthesia, one to three nights in the hospital, and the recovery can be significant for some. Further, with a durability of about seven to 10 years, redoing a TURP was often a reality for many patients. With technological advances, we now have several minimally invasive non-surgical options for qualifying patients. One such option is an implant-based BPH treatment known as Urolift. Urolift is unique because it does not destroy prostatic tissue but increases urethral size leading to reduced lower urinary tract symptoms (LUTS).

How Urolift Works

Urolift is typically performed in an outpatient surgical setting but can also be performed in-office and represents a noninvasive, effective option. Patients can opt for mild or complete sedation. This determination will also be made based on the patient’s general health and ability to tolerate anesthesia. Working through the urethra and not using incisions, Dr. Kapadia uses specially made instruments to deploy suture-like implants that pull the prostatic tissue apart, thus opening the urethra. The result is improved lower urinary tract symptoms (LUTS), including urgency, frequency, feelings that the bladder has not emptied fully, weak stream, and more.

Recovery from Urolift is relatively straightforward. Most patients will not need a catheter. They will be discharged from the surgery center on the same day and require one or two days before they can return to work. Within a short period after that, they will return to regular activity.

Results and Durability of Urolift

Because Urolift does not involve any destruction or removal of prostatic tissue, there is no risk for retrograde ejaculation, which can be experienced in patients undergoing other minimally invasive BPH procedures. Most patients experience relief for five years, possibly more, which is in line with other minimally invasive BPH treatment options. It is worth noting that since Urolift does not destroy prostatic tissue, the prostate continues to grow. Eventually, the procedure will no longer offer its early benefits.

With that said, one of the great benefits of Urolift and other in-office BPH procedures is that they do not preclude the use of other surgeries or procedures to address renewed enlarged prostate symptoms in the future.

Risks and Considerations of Urolift

Because the Urolift procedure is often performed in a surgery center setting, it can be more expensive than an in-office BPH procedure. This is especially true for patients with a high deductible health insurance plan. Medicare and all commercial carriers cover this procedure when medically appropriate. Out-of-pocket costs will largely depend on the specific plan and any supplemental insurance the patient may have; we encourage patients to contact our office to learn more about the costs and speak to Dr. Kapadia about other options if it should be an issue.

While the risks of Urolift are relatively low, and most procedures are uncomplicated, there is always a risk of early implant failure. By some estimates, approximately 7% of all patients will require a second procedure within two years. This increases to about 14% of patients at four years¹. While these are by no means very high numbers, some patients may wish to undergo a less involved office BPH treatment before considering Urolift if they qualify.

There is an unlikely potential for infection or a large hematoma. Both concerns must be treated emergently. While rare, patients should be on the lookout and can find details on what to expect and what is unusual in their post-procedure packets.

Most importantly, patients should know they have options to treat an enlarged prostate. This is a common concern in middle age and older males and should not be ignored. Please speak to Dr. Kapadia for more information on the wide variety of BPH treatments and schedule a consultation to discuss the next steps.

References:

  1. 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.

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