Benign prostatic hyperplasia (BPH) is a very common condition in which the prostate enlarges as men get older. Over 70% of men in their 60s have symptoms of BPH that affects more than 500 million men worldwide1. In fact, BPH is more common than prostate cancer2.
This year in Australia alone over 1 million men will suffer from lower urinary symptoms due to an enlarged prostate3.
On one end of the treatment spectrum, ongoing and daily medications improve symptoms, but some men discontinue therapy for a variety of reasons including insufficient symptom relief or side effects (including sexual dysfunction, dizziness or hormonal imbalance4,5).
On the other end of the treatment spectrum, surgery removes prostate tissue by resection or vaporisation, which is effective but also can be associated with permanent incontinence and sexual dysfunction6,7.
The UroLift® System offers patients a minimally invasive alternative to ongoing medical therapy or traditional BPH tissue removal surgeries. This procedure revolves around tiny prostate retractors, which are permanently implanted to hold the enlarged prostate lobes open. This relieves prostate obstruction and opens the urethra directly without cutting, heating, or removing prostate tissue, typically without the need for a postoperative catheter8.
It is a relatively quick procedure (typically under an hour) with some patients experiencing symptom relief as early as two weeks post procedure, without the lengthy recovery times and complications of traditional BPH surgery8-10. Healing and recovery have been shown in clinical trials to be swift, with rapid symptom relief and improved quality of life with sustained results to at least five years17.
Most common adverse events reported include hematuria, dysuria, micturition urgency, pelvic pain, and urge incontinence. Most symptoms are mild to moderate in severity and resolve within two to four weeks after the procedure.
As well as offering rapid relief, a unique benefit of the system is that clinical studies have shown that it preserves sexual function8. This compares favourably to the 40%-80% rate of retrograde ejaculation and anejaculation published for TURP and laser treatments, and up to 10% rate published for medications6,7,12-16. Erectile function has also been preserved, compared to the widely published 10% erectile problem rate associated with TURP and laser6,7,12-16.
Although the UroLift device itself was engineered in California, the surgical technique was refined through clinical research conducted here in Australia. This research has been conducted since 2005, and it has been published in over 20 International peer-reviewed publications.
The procedure is now an easily accessible option in Australia, and is reimbursed through private health insurance which is of benefit to the one million Australian men who will suffer from lower urinary symptoms this year, due to an enlarged prostate3.
Prostatic cross sectional view
Needle deployed through compressed prostate lobe into the peri-prostatic space
Needle retracting leaving UroLift® implant deployed
Patient’s right implant fully deployed with left implant partially completed
Four UroLift® implants deployed retracting lateral prostatic lobes creating an unobstructed urethral channel
View video animation of the procedure (video courtesy of NeoTract® Pty Ltd).
1. Berry, et al., Journal of Urology 1984
3. Martin SA, et al. World J Urol 2011
4. Roehrborn CG. Rev Urol 2008;10(1)
5. Verhamme KM, et al. Eur Urol 2003
6. McVary KT et al. AUA Guidelines 2010
7. Roehrborn CG et al. AUA Guidelines 2003
8. Roehrborn et al. J Urology LIFT Study 2013
9. McNicholas TA, et al. Eur Urol 2013(64)
10. Barkin J, et al. Can J Urology 2012
11. Woo HH, et al. J Sex Med 2012
12. Oelke M et al. EAU 2011
13. Stucki P, et al. AUA 2013 Meeting
14. Elshal AM, et al. AUA 2013 Meeting
15. McVary KT, et al. J Sex Med 2014
16. Woo HH, et al. J Sex Med 2012
17. Roehrborn, 5-year LIFT study results, AUA 2017
AUTHOR | Dr Justin Chee
Dr Justin Chee is a Melbourne trained urological surgeon sub-specialising in reconstructive urology based at Epworth Freemasons. Dr Chee was an early adopter of the UroLift System technology for prostatic enlargement and was involved in its post-study introduction into Victoria. Dr Chee has organised and led several training workshops at Epworth Freemasons. View profile on Epworth Find a Doctor PH | 03 9088 5138 WEB | http://www.murachealth.org