Minimally Invasive Urinary Relief for Men.
Read Dr. Nimeh's recent article on minimally invasive options for men with enlarged prostate
UroLift® Treatment for Urinary Relief.
Prostatic Tissue Approximation (Urolift) The Urolift is a prosthesis that resembles a small suture connected to an anchor that is implanted under endoscopic guidance with the aim of retracting the prostatic urethra toward the prostatic capsule to open the prostatic urethral space.
It is constructed from two tabs, a stainless steel urethral tab and a nitinol capsular tab. A needle is deployed transurethrally beyond the prostatic capsule and delivers suture-based implants that are placed under tension (see the video above). This mechanically retracts the prostatic lobes to open the prostatic urethral space. This procedure can be performed on an outpatient basis under local anesthetic block - which is really great because you can avoid going under general anesthesia and this can be done in the office.
Urolift has been found to have significantly lower morbidity than other surgical treatments surgical treatments for BPH-associated LUTS. Documented complications include hematuria, dysuria, and bladder spasms. An expanded Australian multicenter study was performed in 2012 that evaluated 64 patients who received the Urolift procedure with follow-up up to 2 years. This study found a reduction in IPSS scores from a mean baseline of 22.6 to 12.6 after 2 years. Peak flow rate at 2 years increased to 10.3 mL/s from a baseline of 7.4 mL/s. Re-treatment was necessary in 20% of men treated and included either photoselective vaporization of the prostate or TURP.
Are you a candidate for UroLift?
If you have one of the following symptoms you should ask Dr. Nimeh about UroLift:
Nocturia (having to rise at night to urinate)
Urinary urgency may occur and manifests as a need to pass urine quickly for fear of incontinence.
Hesitancy occurs when he has to stand at the toilet for a while before he can initiate micturition.
Poor stream and dribbling after finishing
Incomplete bladder emptying gives the sensation of still having urine in the bladder, no matter how often he goes. He may even be able to pass more immediately after he has finished.
There may be a need to push or strain, increasing the risk of micturition syncope.
More Information on Urolift:
What is the UroLift System?
The UroLift® System treatment is a minimally invasive approach to treating an enlarged prostate, or BPH, that lifts or holds the enlarged prostate tissue out of the way so it no longer blocks the urethra. There is no cutting, heating or removal of prostate tissue.
Clinical data has shown that the UroLift System treatment is safe and effective in relieving lower urinary tract symptoms due to BPH without compromising sexual function (1,4). The goal of the UroLift System treatment is to relieve symptoms so you can get back to your life and resume your daily activities.
Most common side effects are light blood in the urine, some pain or discomfort when urinating, some increased urge to go and discomfort in the pelvis that typically resolve within two to four weeks after the procedure.
Advantages of the UroLift System:
Rapid symptom relief, better than reported for medications (2)
Risk profile better than reported for surgical procedures such as TURP (3)
Preservation of sexual function
Return to normal activity in days not months
Increased quality of life
No ongoing BPH medications
19 clinical study publications; 4 years published clinical data
How the UroLift works:
The UroLift System treatment is a straightforward procedure that is performed by a urologist. The urologist places tiny implants to hold the prostate lobes apart, like open curtains on a window, to relieve compression on the urethra. This allows urine to flow normally again. The UroLift System treatment can be done in the physician’s office under local anesthesia. Typically, patients return home the same day without a catheter. (2)
How the UroLift System Works
Frequently Asked Questions:
1. What is the UroLift® System?
The UroLift® System is a new minimally invasive treatment designed to treat lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH).
2. How does the UroLift System work?
The UroLift System consists of a delivery device and tiny permanent implants. FDA cleared in 2013, this unique technology works by directly opening the urethra with tiny implants that hold the enlarged tissue out of the way, like tiebacks on a window curtain. No cutting, heating, or ablating tissue is involved, making the UroLift System the first and only BPH treatment that does not remove prostate tissue and does not negatively impact a man’s sexual function.
3. How do I know if the UroLift System treatment is right for me?
The UroLift System is a proven treatment option for BPH patients who are looking for an alternative to drugs or major surgery. You may be considering or scheduled for a TURP/Laser treatment, or are unhappy with or have stopped taking medications. The UroLift System is appropriate for patients seeking a minimally invasive treatment and are concerned about preserving their sexual function and their quality of life.
4. What should I expect during the UroLift System treatment?
If you and your doctor decide that the UroLift System treatment is right for you, your doctor will provide the specific, detailed information relating to your condition. In general, the UroLift System is a minimally invasive treatment that entails minimal downtime. Your doctor will use the UroLift delivery device to deploy permanent implants to relieve obstruction caused by the enlarged prostate that is pressing on your urethra. The procedure may be performed under local or general anesthesia and you may be given medication to feel comfortable during the treatment. Typically, no catheter and no overnight stay is required post-treatment.
5. What happens post-treatment, during the recovery period?
After the treatment, almost all patients go home the same day without a catheter. There is minimal downtime post-treatment and many patients experience symptom relief in as early as 2 weeks. Patients may experience some urinary discomfort during the recovery period. The most common side effects may include light blood in the urine, some pain or discomfort when urinating, some increased urge to go and discomfort in the pelvis that typically resolve within two to four weeks after the procedure.
6. Will having the UroLift System treatment affect my sexual function?
Sexual function has been preserved among the hundreds of patients treated in our clinical studies.(1,2,3,4) This is a unique benefit of the UroLift System treatment compared with other BPH therapies such as TURP, laser, and even medication.
7. Is the treatment permanent?
The UroLift Implant is a permanent implant, and the treatment is intended to be permanent. Durability has been shown to at least 4 years in U.S. clinical data,(1) and results will continue to be published as follow-ups continue. One unique aspect of the UroLift System is that it does not preclude retreatment or other BPH treatments, should that be needed and desired in the future.
8. What happens if the implants need to be removed?
The implant is made up of standard surgical implantable materials: a nitinol capsular tab, a stainless steel urethral tab, and polyester suture that holds the two tabs together. Your doctor can simply remove the implant, if needed. The suture can be cut and the urethral endpiece can be retrieved with a standard grasper. The capsular tab will remain outside the prostate capsule in place.
9. Are there any contraindications?
The primary contraindications are an obstructive or protruding median lobe of the prostate and a prostate with a volume of >80cc.
10. Will the implants interfere with having an MRI?
Non-clinical testing has demonstrated that the UroLift Implant is MR Conditional. That means that you can be safely scanned in an MR system meeting the following conditions:
Static magnetic field of 3 Tesla or less
Maximum spatial gradient magnetic field of 1500 Gauss/cm (15 T/m) or less
Maximum MR system reported, whole body averaged specific absorption rate (SAR) of 4 W/kg (First Level Controlled Mode)
Under the scan conditions defined above, the UroLift implant is expected to produce a maximum temperature rise of 2.4°C after 15 minutes of continuous scanning.
In non-clinical testing, the image artifact caused by the device extends approximately 15 mm from the UroLift Implant when imaged with a gradient echo pulse sequence and a 3 Tesla MRI system.
Patient implant cards are provided to inform the patient that the UroLift implant is MR Conditional and can safely be scanned only under specific MR conditions.
If you have any questions about MRI safety, please consult your doctor.
11. Will the UroLift implants affect a digital rectal exam (DRE)?
No. The implants are placed on the anterior (front) side of the prostate, and a DRE is conducted on the posterior (back) side of the prostate. The implants are not expected to interfere in a DRE.
12. What clinical data is available for the UroLift System?
Over 950 patient-years of clinical data has been presented in peer-reviewed publications to date demonstrating that the UroLift System is safe and effective. Clinical studies have been conducted in the United States, Canada, Europe and Australia.
13. How do I find out if my health plan covers the UroLift System treatment?
The first step is to make an appointment with your urologist to determine if you
are an appropriate candidate for the treatment. Your physician’s office staff can work with you and your health plan to learn more about your healthcare benefits specific to the UroLift implant procedure.
14. Does Medicare cover the UroLift System?
Yes, all Medicare carriers provide benefits for the UroLift System when medically necessary. Discuss the UroLift System with your physician to determine if the UroLift treatment is an option for you.
15. Who performs the UroLift System treatment?
A urologist, a doctor who specializes in the treatment of diseases of the urinary system and sex organs, uses the UroLift System to treat urinary symptoms due to BPH. The urologist completes comprehensive training prior to using the UroLift System. Find a UroLift System doctor.
16. Where is the UroLift System available?
The UroLift System is available for sale in the United States, Europe, Canada and Australia.
17. Who manufactures the UroLift System?
NeoTract, Inc. manufactures the UroLift System. The company is based in Pleasanton, California.
Do you think an urolift is best for you?
BOOK AN APPOINTMENT ONLINE
OR CALL 907-328-0989 TODAY!
McVary J Sex Medicine 2014
Roehrborn J Urology 2013; 2003 AUA Guidelines
Sonksen J Urology 2016
Roehrborn Urology Clinics 2016