What is BPH?

Benign Prostatic Hyperplasia, or BPH, is a condition in which the prostate enlarges as men get older. BPH is a very common condition that affects over 40 million Americans and over 500 million aging men worldwide. Over 40% of men in their 50s and over70% of men in their 60s have BPH¹. While BPH is a benign condition and unrelated to prostate cancer, it can greatly affect a man’s quality of life.

As the prostate enlarges, it presses on and blocks the urethra, causing bothersome urinary symptoms such as:

  • Frequent need to urinate both day and night
  • Weak or slow urinary stream
  • A sense that you cannot completely empty your bladder
  • Difficulty or delay in starting urination
  • Urgent feeling of needing to urinate
  • A urinary stream that stops and starts

If you suffer from the above symptoms, you are not alone. BPH is the leading reason men visit a urologist.²

You can measure the severity of your BPH symptoms by taking the International Prostate Symptom Score (IPSS) questionnaire.

  1. Berry, et al., Journal of Urology 1984
  2. IMS Health NDTI Urology Specialty Profile Report 2013

The UroLift® System Treatment

What is the UroLift System?

Treatment with the UroLift® System uses a minimally invasive approach that provides rapid relief and recovery of BPH symptoms.¹ It is an earlier treatment option that can get men off BPH medications and avoid major surgery. The goal of the UroLift System treatment is to relieve symptoms so you can get back to your life and resume your daily activities.

The UroLift® System treatment has demonstrated a significant improvement in quality of life for patients compared to medications.2,3The UroLift® System is the only BPH procedure shown not to cause new and lasting erectile or ejaculatory dysfunction*, while being a safe and effective treatment of lower urinary tract symptoms due to BPH.1,3-6

How Does The UroLift® System Work?

The UroLift® System uses a revolutionary approach to treating BPH that lifts and holds the enlarged prostate tissue so it no longer blocks the urethra. It is the only available BPH treatment performed by a urologist that does not require heating, cutting, or removal of the prostate tissue. The procedure is typically performed using local anesthesia in a physician’s office or ambulatory surgery center. Patients typically return home the same day without a catheter.1

  1. Roehrborn, J Urol 2013, L.I.F.T. Study
  2. AUA Guidelines 2003
  3. Roehrborn et al. Can J Urol 2017
  4. Roehrborn, Can J Urol 2015, 3-Year L.I.F.T. Study
  5. Roehrborn, Urology Practice 2015, 2-Year L.I.F.T. Study
  6. Roehrborn Urology Clinics 2016

*No instances of new, sustained erectile or ejaculatory dysfunction

Frequently Asked Questions

1. How is the procedure performed?

Under local or general anesthesia, a scope is inserted into the urethra (you won’t feel anything). Once inside the prostate portion of the urethra, the UroLift® System is introduced inside of the scope. The prostate tissue is compressed and the UroLift® clip is deployed via a needle to the outside capsule of the prostate. This is connected to a second clip by a permanent suture. On average, 4 to 6 clips are placed to hold open the prostate tissue which relieves the obstruction of the bladder. 

2. How do I know if I am a candidate for a UroLift® ?

UroLift® is indicated to treat men 45 years of age and older for BPH symptoms. A visit with a urologist will ensure that there are no other causes for your urinary symptoms. By performing an endoscopy and an ultrasound under sedation in the office, we will determine the size and shape of your prostate and make certain that you are a candidate for the procedure.

3. Is UroLift® covered by insurance?

Yes. All major insurance carriers including Medicare now cover the UroLift® System. Your out-of-pocket expenses will be determined by our office at the time you schedule the procedure.

4. How big are the implants? Will they move or break? Are there any long-term risks to the implants?

The implants are made of nitinol (titanium), stainless steel, and a permanent suture all < 1 cm in size. These materials have been implanted into patients at the time of surgery for many years with no long-term consequences. Once placed, the implants are permanent and will not break, tear or move. The only way to remove the clips would be with another endoscopic procedure.

5. Do you ever need to have the procedure performed again? Does the prostate grow back?

There is a risk for repeat surgery with all procedures. The re-retreatment rate is < 10% and similar to a TURP procedure. There is some evidence in animal studies that the implant causes atrophy (shrinking) that could slow down future prostate growth. If symptoms ever recur after a UroLift® procedure, a repeat evaluation would determine if another implant is necessary. If so, it would be as safe and easy as the first surgery.

6. How long is the recovery after the procedure and what can I expect?

Patients report burning with urination, blood in the urine and worsening urinary frequency/urgency for 3-7 days after the UroLift® procedure. I typically prescribe several short-term medications to minimize these symptoms. About 10% of men will have difficulty emptying their bladder after the procedure. This may require learning self-catheter placement or placement of a urinary catheter for a short period of time. Rarely would any difficulty urinating persist beyond one week. More serious side effects are rarely seen (<1%).

7. Are there any sexual side effects?

No. Unlike medications and more invasive procedures, there are no sexual side effects such as erectile dysfunction or loss of ejaculation with the UroLift® procedure.

8. Will I need to continue my BPH medications after surgery?

Typically men continue their current BPH medications for 2-4 weeks after the UroLift® procedure while the swelling and inflammation of the prostate subsides. The ultimate goal is to stop the medications. Rarely would patients need to continue these medications long-term.

9. Will the implants affect my ability to have future surgeries on my prostate?

No. If the UroLift® procedure does not relieve your BPH symptoms, you could still have a TURP or other prostate surgery with no increased risk of complications. It is important that you and your doctor discuss continued prostate cancer screening since a UroLift® does not treat prostate cancer. You can still be monitored in the same fashion with PSA blood tests and prostate exams. Should you require future treatment of prostate cancer then having had a UroLift® should not impact your treatment options.

10. Am I unable to have certain X-ray tests because of the implants? Will I set off a metal detector?

Since the implants are very small and secured to the prostate, there are no risks or contraindications to having imaging tests such as an MRIs, CT scans, or ultrasounds. You don’t have to alert airport security either. 

 

Talking to Your Doctor about BPH

BPH is a very common condition and is one of the leading reasons men visit a urologist. Whether you have just started experiencing symptoms or if you’ve tried various medications or even surgery, there are a range of treatment options available.

Before you visit the doctor’s office, you can take this BPH Symptom Quiz, designed by the American Urological Association, to determine the severity of your symptoms. We will discuss your symptoms together to decide which treatment option is best for you.

Schedule an appointment today (615-269-2655) to discuss your BPH symptoms with us.

You can also email me at:

joe@drpazona.com