Urolift represents an exciting new and less-invasive procedure for treatment of prostate enlargement and bothersome urinary symptoms.
The procedure takes only about 10 minutes and uses tensioned implants placed using a camera passed up the penis. There is no need for any cutting or incisions. These implants hold the lobes of the prostate apart, similar to pulling back window curtains. Although intended to be permanent, the implants can be easily removed during future procedures if needed. It is sometimes performed in patients who are awake, and sometimes light sedation is used.
When to ask a Urologist about Urolift
You should speak with a Urologist about Urolift if you are bothered by how you urinate (slow stream, hesitancy, trouble emptying), and would prefer to avoid oral medications or find medications insufficient to help your symptoms. The procedure is especially appropriate for men interested in maintaining ejaculation as other treatments for enlarged prostate can cause problems with ejaculation.
Cost
Typically covered by most insurances (although coinsurance and deductibles may apply). Coverage will be verified prior to proceeding. If you do not have insurance, our office will be able to give you an out-of-pocket cost estimate.
Effectiveness
Urolift has shown an average IPSS symptom score improvement of 50% and a 3.5 cc/sec increase in maximum flow rate. These results are stable and durable to at least 5 years (current studies do not go longer than 5 years). Over the same period, only 13% of men required a repeat procedure. It is important to note that, as this is a newer technology, the efficacy and need for retreatment is not as well known as with more established techniques.
Possible Side Effects
The risks of the procedure include pain, bleeding, infection, damage to surrounding structures, difficulty urinating, worsening of urinary symptoms and the risks of anesthesia. These risks are substantially lower than the traditional procedures for enlarged prostate, such as TURP and laser prostatectomy. There has been no reported cases of sexual dysfunction. No patients have developed new erectile dysfunction or lack of ejaculation after this procedure!
Alternative Approaches
Alternatives to Urolift may include observation without treatment, oral medications, chronic catheterization, or other minimally-invasive outlet procedures.
What to do to Prepare for Surgery
You will receive detailed instructions from the surgical schedulers regarding any necessary testing or appointments prior to surgery. In general, you should temporarily stop blood-thinning medications prior to surgery (when to stop depends on the type of blood thinner). Prescription blood-thinning medications should be stopped following clearance from the doctors that prescribed them though other medications that thin the blood including fish oil and pain relievers such as ibuprofen should be stopped as well.
On the day before surgery, you will receive a phone call alerting you to the time that you should arrive.
You should not eat or drink anything after midnight on the day of surgery, but you may take approved home medications in the morning before surgery with a small sip of water.
What to Expect after Surgery
After Urolift, only half of men need a catheter and when needed it is typically only for 1 day. Some men experience irritation from the procedure and may have the need to urinate more urgently or frequently for the first weeks or months after the surgery. You will have periodic visits with your doctor to make sure your symptoms improve appropriately. Most men are able to eventually stop taking their bladder and prostate medications although your doctor will discuss with you what to stop taking and when.