What to expect

What Is the UroLift Procedure?

The UroLift procedure is a minimally invasive treatment option for patients with lower urinary tract symptoms caused by benign prostatic hyperplasia (BPH)—the medical term for an enlarged prostate gland.

This procedure involves the insertion of tiny implants into a patient's urethra, the channel that carries urine from the bladder through the penis. This is done with the UroLift System, a special delivery system approved by the U.S. Food and Drug Administration (FDA). The implants unblock the urine flow from the patient's urethra by pushing excess prostate tissue out of the way.

Besides causing a rapid improvement in symptoms, the UroLift procedure has the added benefit of preserving sexual function. That said, for some patients who undergo this treatment, BPH symptoms eventually return.

How It Works:

The UroLift procedure takes less than an hour and is performed in a urologist's office under local anesthesia.

At the start of the procedure, the urologist inserts a special device into the patient's urethra. When the device reaches the prostate, it releases multiple small implants. Each implant is made of a nickel-titanium capsular tab and a stainless steel urethral tab held together by a polyester suture.

These implants "lift" or push away prostate tissue blocking the urethra. As a result, the urethra is widened, allowing urine to pass easily out of the body.

A unique advantage of the UroLift procedure is that, unlike medications and other surgeries used to treat BPH, it does not cause sexual side effects such as erectile or ejaculatory problems.

A disadvantage of the UroLift procedure is that while the implants are intended to be permanent, some patients develop recurrent symptoms, requiring a repeat procedure or another type of prostate surgery.

Purpose

 The UroLift procedure aims to treat lower urinary tract symptoms caused by BPH in men aged 45 and older.

 BPH symptoms result from an inability to fully empty the bladder because excess prostate tissue is slowing or blocking the flow of urine.

 The symptoms most commonly experienced by men with BPH are:

• Urinating a lot, both during the day and night
• Experiencing a weak urine stream
• Leaking or dribbling urine
• If the above symptoms develop, medication is usually tried first. Surgery is often considered if medication fails or if a patient cannot tolerate its side effects.

 Potential Risks

The most common side effects associated with a UroLift are temporary and include:

• Discomfort when urinating
• Increased urinary frequency
• Inability to control the urge to urinate
• Pelvic pain
• Some blood in the urine
• Rarely, significant bleeding and infection may occur. 

Medications

If you take aspirin or another type of blood thinner, your doctor might ask you to stop a week before your procedure.

Be sure to tell your doctor about the drugs you are taking, including prescription and over-the-counter medications, herbal products, vitamins, and recreational drugs.

Your doctor may prescribe you an antibiotic to begin taking the day before your procedure. You may also be advised to take Motrin (ibuprofen) tablets one hour prior to your UroLift (assuming you are not allergic).

During the Procedure

When it's time to begin the procedure, you will lie on your back with your knees bent and your legs supported by padded footrests attached to the table.

Your urologist will then proceed with the following steps:

• Anesthesia administration: A catheter will be placed in your bladder to drain urine and inject a chilled liquid numbing medication called lidocaine. Lidocaine gel will also be used to numb your urethra. The catheter will then be removed, and your penis will be clamped for a 20-minute period with an external device that applies gentle pressure.
• Visualization: The urologist will insert a thin surgical instrument with a small camera attached to it (called a cystoscope) through your urethra until it reaches your bladder.
• UroLift delivery device placement: Once the cystoscope is in your bladder, part of it will be replaced with the UroLift delivery device. This device is rotated and moved so that excess prostate tissue is accessed and compressed. During this time, you may feel some mild pressure or an urge to urinate.
• Implant delivery: Two to six small implants will be delivered through a small needle that comes out of the UroLift delivery device and into the prostate. You may hear a "click" when the implant is being delivered.
• Device removal: The UroLift delivery device will be removed, and you will be assisted up from and off the table.

After the Procedure

After the procedure, you will be asked to use the bathroom to urinate. You may notice some burning at the tip of your penis or a stinging sensation when you urinate. This is normal: The lidocaine is starting to wear off, and your urethra is a bit sore from the procedure.

Once you urinate, you will get dressed and be sent home to recover.

If you have trouble urinating after the procedure, your doctor may insert another catheter in your bladder. Some patients go home with this catheter to help them void.

After you discuss any questions or concerns about your procedure or recovery, you will get dressed and leave your urologist's office.

Recovery

As you recover at home, you may experience some achiness in your lower abdomen/pelvis and mild discomfort when sitting.

You may also notice that you have to urinate more frequently and have some blood in your urine.

All of this is normal and should resolve within two to four weeks.

During this time, it's important to follow your doctor's post-operative instructions, which may include:

• Take your pain medication—typically a nonsteroidal anti-inflammatory drug (NSAID), like Motrin (ibuprofen)—as needed.
• Continue and finish your antibiotic as prescribed. 
• Stay hydrated by drinking 1.5 to 2 liters of water throughout the day.
• Avoid drinks and foods that may irritate your bladder (e.g., caffeine, alcohol, or spicy/greasy foods).

If you had a catheter placed after your surgery to help urinate, see your doctor or their nurse (usually one to three days later) to have it removed.

Be sure to confirm postoperative activity restrictions with your doctor. Some doctors recommend a week of lighter activity and avoiding sex for a week. Others say it's OK to resume normal activities within a day or two after the UroLift, assuming you are feeling up to it.

When to Call Your Doctor

Call your doctor if you experience any of the following symptoms:

• Fever and/or chills
• Blood in your urine after two weeks or excessively bloody urine
• Painful or swollen testicle or scrotum (may be a sign of infection)
• Inability to urinate

Your first follow-up visit will be around two weeks after your procedure. At this appointment, your doctor will monitor you for complications, ensure you can empty your bladder appropriately and review improvements in your BPH symptoms.

Long-Term Care

Research has found that the UroLift procedure offers a rapid improvement in BPH symptoms—close to 90% greater compared to a sham procedure—and improves patients' quality of life.

 That said, it may take around three months to see the full results of your UroLift procedure, which is why it's important to attend all of your follow-up appointments.

 After your first post-operative appointment, you can expect to see your surgeon one, three, and six months after the procedure. Annual visits usually follow these.