UROLIFT

Some patients prefer not to take medication regularly or have experienced side effects from the medication and want to explore other options. Other patients may notice that the medication no longer has the initial symptomatic relief. In this scenario, they may be a candidate for a new treatment called Urolift, following assessment by an accredited urologist trained in the Urolift procedure. There are a number of urologists at Strathfield private hospital providing this service.

Urolift is small permanent retractor (anchor) that a urologist places into the enlarged prostate lobe to hold the prostate tissue out of the way allowing easier passage of urine flow for the patient. Using a cystoscope, around, 4-5 urolift anchors are placed per patient (depending on the size of the prostate gland). There is no cutting, heating or removal of prostate tissue. 

It is a minimally invasive procedure, which means the patients generally recover faster (most patients are able to go home the next day),than the traditional TURP (Trans Urethral Resection of the Prostate) technique. TURP still remains the gold standard technique for treating an enlarged prostate . Other suitable alternatives include laser prostate surgery which have similar durable functional outcomes to TURP.

ADDITIONAL INFORMATION

Advantages of Urolift

  • Easier to pass urine (Qmax~4mls/sec improvement noted sustained to 4years)
  • Preservation of antegrade ejaculation (no de novo cases of sexual dysfunction reported in any of the studies published). Compare this with transurethral resection of the prostate (TURP), which a recent systematic review found to cause retrograde ejaculation in >75% of men receiving it. 
  • Most patients are catheter-free on discharge. 
  • Most patients can be discharged within 24hrs of the procedure being performed.

Disadvantages

  • Transient pelvic pain and dysuria (burning sensation) can occur. 
  • At medium term follow up, there have been no major complications cited. 
  • Urolift compares more favourably than TURP, which is associated with urinary tract infections (2.3–5%), stricture formation (2.2–9.8%), bladder neck contractures (0.3–9.2%) and retrograde ejaculation (53–75%).
  • Patients with obstructive median lobes, larger prostate volumes and a history of urinary retention may not be suitable candidates for Urolift. 
  • In patients with a high bladder neck and/or long prostatic urethral length, placing a Urolift may be challenging.
  • A number of studies published with short-term (12 month) outcomes
  • Only one study with follow up data >2 years, which shows a re-treatment rate of ~10%.

Side Effects

  • Transient pelvic pain and dysuria (burning sensation) can occur. 
  • At medium term follow up, there have been no major complications cited. 
  • Urolift compares more favourably than TURP, which is associated with urinary tract infections (2.3–5%), stricture formation (2.2–9.8%), bladder neck contractures (0.3–9.2%) and retrograde ejaculation (53–75%).

Procedure

The small Urolift transprostatic tissue retractor is made from commonly used implantable materials. Typically, 4-5 retractors are used per patient.