Benign Prostatic Hyperplasia (BPH) commonly affects many men as they age. The UroLift System has emerged as a minimally invasive treatment option that offers relief from the symptoms of BPH. In this blog post, Dr. Bevan-Thomas will answer the 10 most common questions about the UroLift procedure to help you understand this innovative treatment better.

1. What is the UroLift System?

The UroLift System is a minimally invasive procedure designed to treat BPH by lifting and holding the enlarged prostate tissue out of the way so it no longer blocks the urethra. Think about driving through a tunnel. Now think about 2 giant marshmallows closing the opening from either side of the tunnel, making it very difficult to drive through to the other side. This is a simplified analogy to what happens to the prostate for men who begin having symptoms of BPH. The tunnel is closing, and the Urolift procedure opens it to make it easier to pass urine. This procedure does not involve cutting, heating, or removing prostate tissue, making it a less invasive option compared to traditional surgeries like TURP (Transurethral Resection of the Prostate).

The UroLift System uses small implants to hold the prostate lobes apart, which relieves compression on the urethra and allows urine to flow more freely. This approach is particularly beneficial for men who want to avoid the side effects associated with more invasive procedures, such as sexual dysfunction and incontinence.

2. How Does the UroLift Procedure Work?

The UroLift procedure involves the use of a delivery device that is inserted through the urethra to access the enlarged prostate. Remember this simple concept – men urinate through the middle of the prostate. Think of the tunnel analogy above. Small implants are then placed to lift and hold the prostate tissue, creating a wider urethral opening and improving urine flow. The procedure is typically performed under local anesthesia or at the outpatient surgery center under anesthesia. Dr. Bevan-Thomas can perform the Urolift in the office under nitrous gas but often recommends the outpatient surgery center to make it even easier for the patient.

During the procedure, Dr. Bevan-Thomas uses a cystoscope in the urine channel to visualize the prostate and place the implants. Each implant is delivered through a needle that is passed through the urethra and into the prostate. The implants are made of a permanent material that does not degrade over time, ensuring long-lasting results. These implants are so small that they rarely cause any issues – even many years later. Think about a staple with a string attached on each end, but the Urolift uses Nickel instead of metal. The prostate tissue routinely grows over the small implant. Finally, the implants do NOT set off metal detectors and are safe for MRI machines but patients should notify the imaging center ahead of any MRI to make them aware.

YOUTUBE Urolift procedure below.

3. Who is a Candidate for the UroLift Procedure?

Ideal candidates for the UroLift procedure are men with BPH symptoms who have a relatively small to moderate-sized prostate gland. It is also suitable for those who have not responded well to medication and are looking for a treatment option that preserves sexual function.

Men with severe urinary symptoms, such as frequent urination, weak stream, and difficulty starting and stopping urination, may benefit from the UroLift procedure. By opening the urinary channel, the bladder can empty more easily, and the pressure in the bladder decreases, thus making it easier to urinate with a better stream, faster emptying, and less waking up at night to urinate.

Determining whether a man needs a UroLift procedure involves assessing the severity of the BPH symptoms. The International Prostate Symptom Score (IPSS) is a widely used tool to evaluate the severity of urinary symptoms associated with BPH. The IPSS questionnaire consists of seven questions related to urinary symptoms, such as frequency, urgency, weak stream, and nocturia (nighttime urination). Each question is scored on a scale from 0 to 5, with higher scores indicating more severe symptoms. The total IPSS score ranges from 0 to 35, with scores categorized as follows:

0-7: Mild symptoms
8-19: Moderate symptoms
20-35: Severe symptoms

If a man’s IPSS score is greater than 10, it is advisable to consider BPH treatment options to improve your quality of life. Men with moderate to severe symptoms often experience significant improvements in their daily activities and overall well-being after undergoing treatments like the UroLift procedure.

The size and anatomy of the prostate are the 2 most important aspects of evaluating men who may be candidates for the Urolift procedure. Men with a prostate about the size of a small plum (50 cm³ )or less are usually good candidates for the Urolift procedure. Not all men are built the same, however. Some prostates can grow to the size of 400 cubic cm³ or larger(a large grapefruit). Knowing the size and anatomy is vital to understanding the best treatment for that man. The implants are only built for smaller to medium-sized prostates. Dr. Bevan-Thomas will perform a prostate ultrasound and perform a cystoscopy (look inside the urine channel) on every patient. That is where we begin the journey.

4. What are the Benefits of the UroLift System?

The UroLift System offers several benefits, including:

Rapid relief of BPH symptoms
Minimal downtime and quick recovery
Preservation of sexual function, with no new or lasting erectile or ejaculatory dysfunction
No need for cutting, heating, or removal of prostate tissue
Typically performed as an outpatient procedure

One of the most significant advantages of the UroLift System is its ability to provide rapid symptom relief. Many patients experience improved urinary symptoms within a few days of the procedure. Additionally, the UroLift System has a lower risk of complications than more invasive surgical options, making it an attractive choice for many men. Dr. Bevan-Thomas routinely sees patients see improvement within the first few weeks after the procedure, but this continues to improve for the first 4-6 months as the bladder relaxes.

5. What are the Risks and Side Effects of the UroLift Procedure?

As with any medical procedure, there are potential risks and side effects. Common side effects of the UroLift procedure include pain or burning with urination, blood in the urine, pelvic pain, and an urgent need to urinate. These side effects are usually mild to moderate and usually resolve within two to four weeks after the procedure.

In rare cases, more serious complications can occur, such as infection, bleeding, or injury to the urethra or bladder. However, the overall risk of complications is low, and most patients tolerate the procedure very well.

6. How Long Does the UroLift Procedure Take?

The UroLift procedure is relatively quick, typically taking less than 10 minutes to complete. Most patients can return home the same day without needing a urinary catheter but must urinate with a good stream after the procedure.

The short duration of the procedure is one of its key advantages, as it allows patients to resume their normal activities quickly. In most cases, patients can return to work and other daily activities within a few days after the procedure. This makes the UroLift System an attractive option for men who want to minimize disruption to their lives.

7. What is the Recovery Time After the UroLift Procedure?

Recovery time after the UroLift procedure is generally short. Most patients experience rapid symptom relief and can return to normal activities within a few days. Full recovery and resolution of any mild side effects usually occur within two to four weeks.

During recovery, patients are advised to avoid strenuous activities and heavy lifting to allow the body to heal properly. It is also important to stay hydrated and follow any post-procedure instructions provided by the urologist. Most patients find that their urinary symptoms continue to improve in the first few weeks following the procedure.

8. How Effective is the UroLift System?

Clinical studies have shown that the UroLift System effectively provides long-term relief from BPH symptoms. Patients typically experience significant improvements in urinary flow and quality of life. The procedure has been shown to maintain its effectiveness for at least five years, but the data continues to show effectiveness and durability well beyond five years.

The efficacy and patient satisfaction with the Urolift procedure have been excellent. The 2 best ways to evaluate this are the IPSS score and the Qmax urinary flow assessment. Dr. Bevan-Thomas has patients fill out the IPSS questionnaire before and after the procedure to assess the patient’s improvement.

What do the studies show?

The UroLift System has been extensively studied, with numerous clinical trials demonstrating its efficacy and patient satisfaction. For instance, the L.I.F.T. study, a prospective randomized controlled study, showed significant improvements in International Prostate Symptom Score (IPSS), quality of life (QoL), and peak urinary flow rate (Qmax) at three-year follow-up, with approximately 10% retreatment and mild adverse events. The five-year follow-up of the L.I.F.T. study confirmed durable improvements in IPSS and Qmax, with no new sustained erectile dysfunction or ejaculatory dysfunction. The IPSS score is the validated questionnaire as described earlier in this blog, and the Qmax is the speed of a urinary stream. The faster the stream, the better the urination and the procedure results.

Moreover, a study presented at the American Urological Association Annual Meeting highlighted that early intervention with the UroLift System facilitates long-term outcomes for BPH patients. The study showed that treatment earlier in the disease positively impacts long-term durability, with a surgical retreatment rate of about 13.6% over five years. Dr. Bevan-Thomas quotes a 10-15% risk of requiring retreatment at 5 years, however, he believes that restricting the Urolift to prostates smaller than 50 g will show better results in the future.

Patient satisfaction with the UroLift System is generally high, with many patients reporting significant improvements in their quality of life and urinary symptoms. The minimally invasive nature of the procedure, combined with its rapid recovery time and preservation of sexual function, makes it a popular choice among men with BPH.

9. How Does the UroLift System Compare to Other BPH Treatments?

The UroLift System is unique in that it does not involve cutting, heating, or removing prostate tissue, which helps preserve sexual function. Compared to traditional surgeries like TURP (aka the roto rooter), the UroLift procedure has a lower risk profile and a quicker recovery time. It is also a good option for patients who do not want to take daily medication or have not responded well to pharmacological treatments.

Comparison with TURP and Other Treatments

In several studies, the UroLift System has been compared to the TURP. The BPH6 study, for example, demonstrated that UroLift is comparable to TURP in terms of quality of life changes but superior in terms of recovery time and preservation of ejaculatory function. Additionally, a head-to-head randomized controlled trial (RCT) comparing UroLift to Rezūm (water vapor thermal therapy) found that UroLift provided more rapid symptom relief and quality of life improvements within the first three months post-treatment.

The UroLift System also offers advantages over medication for BPH. While medications can be effective in managing symptoms, they often come with side effects such as dizziness, fatigue, and sexual dysfunction. The UroLift procedure provides a one-time solution that can offer long-term relief without the need for ongoing medication.

10. What is Dr. Bevan-Thomas’s experience with the Urolift procedure?

Dr. Bevan-Thomas worked with the inventors of the Urolift procedure back in 2003. After many changes in the design, the Urolift became available in the United States in 2013. Dr. Bevan-Thomas advocates for patients who are the appropriate candidates for the Urolift procedure. He is currently a Center of Excellence for the Urolift procedure, which is a designation for Urologists with the added experience to provide patients with the best possible results.

While many patients present to Dr. Bevan-Thomas with questions about the Urolift, he always starts with the symptoms, size and anatomy. As discussed above, if the patients are suffering from urinary symptoms, it must first be established that it is a prostate problem and not a bladder problem. Often, Dr. Bevan-Thomas will recommend urodynamic testing to evaluate the function of the bladder and whether there is a blockage or not. This is a simple test that fills the bladder with water and the patient urinates. It is like an EKG for the bladder. Patients also will need a prostate Ultrasound and cystoscopy to evaluate the size and anatomy.

Additional Insights on UroLift Procedure

Impact on Sexual Function

One of the key concerns for men undergoing treatment for BPH is the potential impact on sexual function and primarily retrograde ejaculation. Retrograde ejaculation occurs when the semen with orgasm goes backward into the bladder. This is not uncomfortable or harmful but does change the feeling associated with orgasms for men. Traditional surgical treatments, such as TURP, are associated with a high risk of retrograde ejaculation. The UroLift System, however, has been shown to preserve sexual function, with most studies reporting no new sustained erectile or ejaculatory dysfunction following the procedure.

Patient Testimonials and Real-World Experiences

Patient testimonials and real-world experiences provide valuable insights into the effectiveness and satisfaction associated with the UroLift procedure. Many patients have reported significant improvements in their urinary symptoms and overall quality of life. Testimonials often highlight the rapid recovery time, minimal side effects, and preservation of sexual function as key benefits of the UroLift System. Dr. Bevan-Thomas has numerous patients who have been helped with the Urolift procedure and sleeping better at night with minimal urinary urgency or frequency during the daytime.

Cost-Effectiveness and Insurance Coverage

The cost of the UroLift procedure can vary depending on factors such as the healthcare provider, geographic location, and insurance coverage. It is important to check with your insurance provider to determine if the UroLift procedure is covered under your plan. Many insurance companies recognize the UroLift System as a medically necessary treatment for BPH and provide coverage for the procedure. After the patient and Dr. Bevan-Thomas have jointly decided that the Urolift procedure is the best choice for the patient, the scheduling staff will walk the patient through the insurance process. This can take up to several weeks.

Do I Need a UroLift?

Start with the IPSS score. If your score is above 10 and you feel like your bladder is starting to dictate your activities, it is time to make an appointment. Dr. Bevan-Thomas will go over all of your options before suggesting a plan.

Remember – it is about the symptoms and then the size and anatomy. Not all men are the best candidates for a Urolift. Dr. Bevan-Thomas offers numerous different approaches for men suffering from BPH. Call and make an appointment now so Dr. Bevan-Thomas can discuss your options. Life is short, don’t let your prostate dictate your lifestyle. New patient slots are opened up every week to address exactly these issues.

References

Recent advances in UroLift: A comprehensive overview – PMC – NCBI
Long-term follow-up of prostatic urethral lift at a single center – PMC
New Data Highlights that Early Intervention with the UroLift® System Facilitates Long-Term Outcomes for BPH Patients
New data show early intervention with the UroLift system improves long-term BPH outcomes
Clinical Results | 145+ Peer-Reviewed Pubs on UroLift–Real Data
Considerations for Minimally Invasive Treatment for BPH
Medium-term efficacy of the prostatic urethral lift – PMC – NCBI
Peer Reviewed Clinical Results from BPH Treatment | Urolift®
BPH Patient Testimonials | Steve K.’s Story – UroLift
Outcomes From Two New Head-to-Head Randomized Controlled Trials Involving the UroLift™ System Highlight a Superior Patient Experience* Against Rezūm and Its Advantage Over Medical Therapy as an Early Intervention for BPH
UroLift® Peer Reviewed Clinical Results | FDA Cleared
UroLift® Peer Reviewed Clinical Results | FDA Cleared
The UroLift implant: mechanism behind rapid and durable relief from BPH
Is UroLift Effective? More Common Questions – Advanced Urology
UroLift Patient Testimonials – Southland Urology
Outcomes From Two New Head-to-Head Randomized Controlled Trials
How Long Can the Results of a UroLift® Procedure Last?
An Update on the Outcomes of Patients Treated with Urolift for Benign Prostatic Hyperplasia
Early patient experience following treatment with the UroLift prostatic urethral lift
UroLift® System Research Data from EAU Highlight Durability and Superior Patient Experience, Along with Benefits of Earlier Treatment for BPH