UroLift Treatment for the enlarged prostate (BPH)
We provide a new treatment called Prostatic Urethral Lift, or UroLift, which is the least invasive surgical treatment for the BPH enlarged prostate (benign prostatic hyperplasia).
When the prostate becomes enlarged, surplus prostate tissue presses down on the urethra (a thin tube which carries urine from the bladder out through to the penis). Like a kink in a hose pipe, this means the man will have some or all of the following symptoms: a weak flow of urine, the feeling of not having emptied the bladder properly and urgent need to go to the toilet.
For the large majority of patients with BPH, treatment begins with medication designed to relax the muscles around the prostate. This can be very helpful. However for others, medication is not fully effective or they dislike the side-effects. In this case, the other options are GreenLight Laser treatment or the TURP. The UroLift system has recently been developed as a less invasive alternative to laser treatment and the TURP; it can be undertaken as day case surgery so that you go on home the same day and avoids the need for the catheter (drainage tube in the penis).
How does UroLift work?
The surgeon inserts tiny implants into your prostate, which lift and hold the two sections of the prostate (called lobes) apart. The implants are then permanently clipped and secured in place. The procedure is similar to drawing apart two curtains with curtain ties.
In doing so, the procedure immediately pushes the prostate tissue away from the urethra. This alleviates pressure on the urethra without lasering or cutting tissue. Typically, there is no need for a catheter afterwards and you can go home on the same day, rather than stay in hospital overnight.
Importantly, with UroLift, there is no retrograde ejaculation (dry orgasm) or impact upon sexual function as well as reduced risk of incontinence and scarring.
What evidence is there for the safety and effectiveness of UroLift?
UroLift was first carried out in America in 2005. Although it is relatively new in the UK, it has been used more extensively in America and continental Europe and two major studies provide valuable data.
The BPH6 study involved 80 patients and was the first to compare outcomes for men having TURP with men having UroLift. This study concluded: “Both PUL and TURP groups achieved significant symptom relief compared to baseline, with a superior symptom relief rate for TURP. PUL was superior to TURP in terms of quality of recovery and preservation of ejaculatory function.”
Another study, called L.I.F.T. provides a longer term perspective, evaluating how effective UroLift is three years after the procedure was carried out. Researchers assessed 206 patients to see how durable UroLift was and found that at three years, 88 per cent of patients reported continued relief from urinary symptoms. Only about one in ten patients required a repeat procedure and half of them chose repeat Urolift. The study concluded:
“Both PUL and TURP groups achieved significant symptom relief compared to baseline, with a superior symptom relief rate for TURP. PUL was superior to TURP in terms of quality of recovery and preservation of ejaculatory function.”
Recent NICE guidance (September 17, 2015) states: UroLift “should be considered as an alternative to current surgical procedures for use in a day-case setting in men with lower urinary tract symptoms of benign prostatic hyperplasia who are aged 50 years and older and who have a prostate of less than 100 ml.”
Is UroLift the right treatment for me?
This approach may be right for you to consider if:
- You have tried taking medication but find it ineffective or are experiencing side-effects
- You have a small to medium size prostate (under 100ml) and you do not have a large central prostate lobe (size and shape of prostate is assessed by the surgeon at local anaesthetic bladder examination or ultrasound preoperatively)
- You would like to preserve the full sexual function, including ejaculation (fertility is not guaranteed)
- You are in a busy job and your work schedule dictates recovery as quick as possible, however with the higher chance of requiring further surgery
- You would prefer not to stay in the hospital overnight
- You are concerned about having laser surgery or a TURP or may not be suitable for either of these more invasive approaches. We will consider your age, overall fitness and other medical conditions and advise you if this is the case