More than 500 million men worldwide suffer from benign prostatic hyperplasia (BPH), or enlarged prostate. Medication and surgery have been the most effective treatment options for symptoms that include trouble urinating, urgency, and painful urination, but a new revolutionary treatment is providing a minimally invasive treatment option for these patients.
Jason Burrus, MD
Urologists Jason Burrus, MD, and Brian Wade, MD, of Urology Centers of Alabama have been successfully treating patients with the Urolift® system for six months. "UroLift® fits a niche for patients who want to stop taking medications for various reasons but don't want invasive surgery or a catheter," Wade says.
Brian Wade, MD
Previously, transurethral resection of the prostate (TURP) was the common surgery used to treat BPH, but that procedure is invasive. "TURP is a good operation, but it requires a hospital stay and can cause incontinence and sexual side effects," Burrus says. "We wanted a less invasive way to help these men. With UroLift®, we don't use have to use energy - heat, electrical current, microwave - like other procedures require to destroy tissue, so there are minimal side effects."
The UroLift® procedure does not require cutting or removal of prostate tissue, and it can be done in a physician's office under local anesthesia. The device is placed through the obstructed urethra to access the enlarged prostate. The urologist places tiny implants to hold the prostate lobes apart to relieve compression on the urethra, allowing urine to flow normally. "It is like pulling back curtains with a curtain stay," Wade says. "It offers rapid relief with essentially no side effects and no down time. It also preserves all sexual function."
The UroLift® system has other advantages over the TURP. According to the National Institutes of Health (NIH), the physician maintains distance from the bladder when implanting the UroLift® device which allows for preservation of antegrade ejaculation. The TURP procedure can cause retrograde ejaculation in up to 75 percent of men.
NIH documentation states, "UroLift® is expected to emerge as an attractive option for men wanting to avoid ablative or cavitating surgery with a high priority of preservation of sexual function. It allows early return to work and rapid symptom resolution with no catheter on discharge. Its popularity from a patient's point of view is self-evident."
UroLift® does have some disadvantages. Patients with large prostates, obstructive median lobes, or a history of urinary retention may not be candidates of the procedure. Patients with a high bladder neck and long prostatic urethral length will be excluded. In contrast to TURP, the UroLift® system does not collect tissue specimens and cannot detect incidental cases of prostate cancer.
Burrus says patients may experience minor side effects from the UroLift® procedure. Most common is blood in the urine for a day or so and short-term burning or urgency. About 10 percent of patients may need a catheter the first night. "Any procedure has potential complications and side effects, but the risk/benefit ratio of UroLift® is better than most other procedures," Burrus says.
From Burrus' and Wade's perspective, the UroLift® is absolutely effective based on the significant drops in symptom scores. "We see a lot of technologies. Some come and go, some improve treatments, and some are not so good," Burrus says. "NeoTract, Inc., manufacturer of the UroLift® System, has kept up with data on this product and on the patients who have had these implants. As a result, we are able to compare studies done on this procedure. We evaluate the studies in terms of symptom relief scores to make sure we are making progress. Based on what we've seen, UroLift® is holding its own, no doubt."
Jason Burrus, MD
Brian Wade, MD