What is it?
Urolift is a minimally invasive treatment suitable for many men who wish to decrease the impact of urinary symptoms on their lives. It is performed from within the urethra and involves pinning back rather than removing the obstructive prostate tissue. It has been approved by the National Institute for health and Clinical Excellence (NICE) for use in the UK.
Who is it suitable for?
Urolift works best in men whose urinary symptoms are due to only mild to moderate lateral (side) lobe enlargement of the prostate. Many men who are taking herbal remedies or prostate relaxing medication, but are having side effects or would rather not be on these, may be suitable for urolift. The key to success with urolift is careful selection of those men most likely to benefit.
Urolift is NOT recommended in men with urinary obstruction due to:
- Enlarged prostate middle lobe
- Total prostate volume greater then 60 grams
- Tight bladder neck
Men who are in urinary retention requiring catheterisation, or who have had urinary tract infections or bleeding due to an enlarged prostate are better off considering a surgical procedure such as HoLEP which is effective in all of the circumstances listed above.
How can I find out if urolift is suitable for me?
In order to determine whether urolift is suitable for your personal situation it is recommended that you consult a urologist who specialises in male lower urinary tract symptoms and offers urolift,. A detailed prostate examination is essential. This includes some or all of the following:
- Digital rectal examination
- PSA blood test
- Prostate ultrasound scan
- Flexible cystoscopy (telescopic examination of the inside of the prostate)
How is it done?
Urolift is usually performed under a short general anaesthetic. In some cases only light sedation and local anaesthetic may be required.
A small telescope is used to pass the urolift device along the urethra. to the inside of the prostate. The obstructive part of the prostate is pushed aside and held out of the way by inserting a urolift implant to pin it back (as illustrated below).
The number of implants required to fully open the channel through the prostate varies according to the size and shape of the prostate. Usually between 2 and 4 implants are used.
Usually there is no need for a catheter after the procedure and most men are ready for discharge from hospital within 4-6 hours of the procedure.
What is the recovery time?
Within 24-48 hours the majority of men are able to resume most if not all of their normal activities. No restrictions are placed on any physical activity. As long as you feel safe, a return to driving is possible after 48hr.
What are the advantages of Urolift?
Urolift has been well studied, including by randomised trial (the highest level of clinical trial).
In summary, the advantages of urolift include:
- It is minimally invasive and does not require the removal of any part of the prostate
- It can be done using light sedation and local anaesthetic
- The procedure time is short (5-10 min)
- No catheter is required in most cases
- Return to normal activities is possible in as little as 48 hours
- It is more effective at relieving urinary flow and symptoms than herbal remedies or prostate medication
- Urinary flow rate improves by 50% (up to twice that of medication),
- Urinary symptoms improve by 50% (up to 2-3 times that seen with medication)
- No sexual dysfunction or urinary incontinence has been experienced in any of the clinical studies to date.
- Urolift does not preclude subsequent surgical procedures such as HoLEP if urinary symptoms recur.
What are the potential disadvantages of Urolift?
The main disadvantage of urolift is that the benefits may not be durable:
- 11% of men required a further surgical procedure for urolift failure within the first 3 years.
- 9% of men recommenced BPH medication due to recurrent urinary symptoms within the first 3 years.
Click here to read our information sheet on UroLift (Link to Urolift info sheet)
Further information on UroLift
NICE interventional procedures guidance [IPG475] On Urolift January 2014
British Journal of Urology 2014 Multicentre prospective crossover study of the ‘prostatic urethral lift’ for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia.
Journal of Sexual Medicine 2014 Treatment of LUTS secondary to BPH while preserving sexual function: randomized controlled study of prostatic urethral lift.
Canadian Journal of Urology 2014 Prospective multi-center study elucidating patient experience after prostatic urethral lift.
European Urology 2013 Minimally invasive prostatic urethral lift: surgical technique and multinational experience.
Journal of Uology 2013 The prostatic urethral lift for the treatment of lower urinary tract symptoms associated with prostate enlargement due to benign prostatic hyperplasia: the L.I.F.T. Study.