Urolift: A New Therapy for Enlarged Prostate

April 13, 2017
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It’s a nuisance condition that plagues many men as they age. Benign prostatic hyperplasia, or enlarged prostate, affects around half of all men by the time they reach 60 and 90% of men older than 80. But treatments to alleviate BPH symptoms are readily available, including a new procedure that may be a perfect fit for some men.

The treatment, called Urolift, was approved by the Food and Drug Administration in September 2013. Urolift has been available in Europe about five years, says Mehran Movassaghi, MD, a urologist at Providence Saint John’s Health Center and medical director of the Men’s Health Center. It’s a simple procedure that provides immediate results.

BPH is a noncancerous condition—more commonly called enlarged prostate—caused by hormonal changes later in life. The prostate is a walnut-sized gland at the base of the bladder. Enlargement from BPH puts pressure on the urethra, narrowing or closing the urinary tract and making it hard to urinate. Men with BPH may urinate more frequently, have trouble going at all or experience incontinence.

Medications for BPH tend to work by either inhibiting prostate growth or relaxing the prostate to improve urinary function. But these medications can become less effective over time, and they can also cause side effects like erectile dysfunction.

“UroLift can be ideal for men who are unhappy with their medication because of sexual side effects or younger men who are sexually active that don’t want to take a pill for rest of their lives,” Dr. Movassaghi says.

Urolift uses small implants placed through the urethra, with the help of a camera, to access the prostate. There is no cutting, heating or removal of prostate tissue and sexual function is preserved. The implants lift the prostate, opening the urethra.

 “We can use from two to six implants, and this allows us to provide relief to the patient without cutting anything or changing the anatomy at all,” Dr. Movassaghi says. “It’s a simple outpatient procedure that takes about 30 minutes and can be done under local or general anesthesia.”

Dr. Movassaghi estimates that around 60% to 70% of men with BPH are likely candidates for this new procedure.

“We have to determine how big the prostate is first,” he says. “If it’s more than 80 grams, UroLift is not a good option. Or if the prostate extends into the bladder, we may have to do UroLift and a partial resection.”

Because the procedure is still new, experts like Dr. Movassaghi can’t say if UroLift patients will experience any reduction in the efficacy of the treatment over the long term. The device is considered permanent. But it won’t interfere with any additional treatments for BPH should they be needed in the future.

Medicare covers the UroLift procedure when it’s medically necessary.

“Prostates grow over time, and every patient’s growth rate is different,” he explains. “But we can look at the data up to five years and see significant improvement in flow rate and quality of life.”

For most men, the UroLift procedure is easy and effective. Patients are often out of the office within a few hours. They go home with a catheter that is removed after 48 hours. Pain is typically minimal. Most patients can return to their usual activities within a few days.