UroLift® System Treatment for Benign Prostatic Hyperplasia, or BPH

Urological Associates of Bridgeport is proud to announce that we now offer an advanced approach to treating Benign Prostatic Hyperplasia, or BPH called UroLift®. The UroLift® System is a new, minimally invasive approach to treating BPH for patients looking for an alternative to drug therapy or more invasive surgery.

ProstateWhat is Benign Prostatic Hyperplasia, or BPH?

Benign Prostatic Hyperplasia, or BPH, is a condition in which the prostate enlarges as men get older. Over 70% of men in their 60s have BPH symptoms so it is very common. While BPH is a benign condition and unrelated to prostate cancer, it can greatly affect a man's quality of life.

The prostate is a male reproductive gland, about the size of a walnut, that produces fluid for semen. The prostate surrounds the urethra, which is the tube that carries urine from the bladder out of the body. 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 one of the leading reasons for men to visit a urologist. Please contact us for a Consultation.

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What is the UroLift® System?

The UroLift® System is a new, minimally invasive approach to treating BPH for patients looking for an alternative to drug therapy or more invasive surgery. The UroLift System is a straightforward procedure that utilizes tiny implants to lift and hold 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 proven that the UroLift System treatment is safe and effective and can improve BPH symptoms 3 to 4 times greater than with medication. Results have shown durability to two years with no impact to sexual function. The goal is to relieve you of bothersome urinary symptoms so you can get back to your life and resume daily activities.

Most common adverse events reported include hematuria, dysuria, micturition urgency, pelvic pain, and urge incontinence. Most symptoms were mild to moderate in severity and resolved within two to four weeks after the procedure.

How the The UroLift® System Works

Normal Prostate

Normal Prostate

Enlarged Prostate

An enlarged prostate compresses on the urethra, making it difficult for urine to flow.

The UroLift Device is placed through the obstructed urethra to access the enlarged prostate.

The device compresses the tissue and delivers tiny implants to lift and hold prostate tissue out of the way, thus opening the urethra. The permanent implants keep the tissue in place, like tiebacks on a window curtain.

The UroLift Device is removed, leaving an open urethra for urine to flow.

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UroLift® System Patient FAQs

Device/Procedure Specifics

What is the UroLift® System?

The UroLift® System is a simple device that is used to treat lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). If a man has trouble with his waterworks, this may be a solution for him. (1,2,14)

How does the UroLift® System work?

It works by pulling back the tissue blocking the urethra, like pulling back curtains on a window. The implants are used to hold the tissue out of the way, so men can void better. (1,2,14,16)

Is the UroLift® System FDA cleared or approved?

Yes. The product was reviewed and cleared by FDA in September, 2013. It is also commercially available in many other countries including Australia, United Kingdom, Germany, and Italy. (1,8,11,14,16)

How long does it last?

The UroLift® Implant is a permanent implant, and the treatment is intended to be permanent. The clinical studies currently show the results can last as long as three years, and the studies are ongoing. It may last longer, but the studies have not gone out that far yet. (16)

What are the benefits of the UroLift® System over other BPH procedures?

The studies show UroLift® System treatment offers a similar level of symptom relief as other BPH procedures and it is very safe, typically having fewer side effects than other procedures. The common side-effects are typically gone in 4 weeks or less. These side effects include some blood in the urine, painful urination, urgency, pelvic ache, and possibly some urge incontinence – again these are typically gone by 4 weeks or sooner. By comparison most other BPH procedures can have permanent side effects including loss of ejaculation, incontinence, and erectile problems. Patients report returning to normal about 9 days after UroLift System treatment, on average. (1,3,9,10,11,12,13, 14)

How does it compare to my BPH medicine?

The UroLift® System treatment offers more symptom relief than BPH medications and has not been linked to the common side effects such as dizziness, light-headedness, and sexual problems. (1,3,9,10,11,12,13,14,15)

Patient Selection

How do I know if UroLift System treatment is right for me?

BPH patients who are looking for an alternative to drugs or major surgery may be candidates for UroLift® System treatment. Patients who are scheduled for another BPH treatment or are unhappy with or have stopped taking medications may also be candidates. The UroLift® System is appropriate for patients seeking a minimally invasive treatment and are concerned about preserving their quality of life. Your doctor will need to do a few simple examinations to determine if you are a candidate for the procedure based on your specific symptoms and anatomy. (1,2,5,14,15,16)

Are there any reasons the UroLift® System may not be right for me?

The primary reason you may not be a candidate for the UroLift® System treatment is an obstructive or protruding median lobe of the prostate. However, you will need to talk to an Urologist who offers the UroLift® System treatment to understand if you are a good candidate for the procedure. (1,2,5,8,14,16)

Is the UroLift® System prescribed for patients with prostate cancer?

The UroLift® System clinical studies to date have included men without active prostate cancer. You should talk to an Urologist who offers the UroLift® System treatment to understand if you are a good candidate for the procedure. (1,8,10,14,16)

Can I have UroLift® System treatment after TURP?

This has not been studied. You will need to speak with the doctor for more information on this. (1,10,14,16)

Can I have UroLift® System Treatment if I have had radiation therapy for prostate cancer?

This has not been studied. You’ll need to talk to an Urologist who offers UroLift® System treatment to understand if you are a good candidate for the procedure. (1,14,16)

Can I have UroLift® System treatment after TUNA/Microwave therapy?

This has not been studied. You will need to talk to an Urologist who offers UroLift® System treatment to understand if your prostate is again blocking your urethra and if your Urologist feels you would benefit from UroLift® System treatment. (1,10,14,16)

Can I have UroLift® System Treatment if I am a watchful waiting prostate cancer patient?

This has not been studied. You’ll need to talk to an Urologist who offers UroLift® System treatment to understand if you are a good candidate for the procedure. (1,14,16)

I suffer from an enlarged Prostate and also have chronic non-bacterial Prostatitis. I have had two TURP procedures and am still unable to empty my bladder. Is the UroLift® procedure right for me?

UroLift® clinical studies did not rule out chronic prostatitis, unless it was bacterial. “Prostatitis” can be a very general term. You will need to talk to an Urologist so that he/she can help you determine the right course of treatment. (1,10,14,16)

Why did the FDA only clear the UroLift® System for men 50 or over?

The 50-year mark is based on the clinical study that was performed. Like most BPH studies, all men in the study were 50 or older. You will need to talk to an Urologist so that he/she can help you determine the right course of treatment. (8,10)

Payment / Out of Pocket

Does insurance cover the UroLift® System treatment?

It depends on your insurance plan. Because the UroLift® System is a newer technology, many health plans are not yet familiar with it; as such, coverage may be decided on a case-by-case basis. Once your Urologist determines that you are an appropriate candidate for the UroLift® System treatment, we will work with your health plan to learn more about your benefits specific to the UroLift® System. (8)

Why don’t some insurers cover this yet? Is it experimental?

The UroLift® System is fully FDA cleared after years of clinical trials. As you may know, insurers need to see how much their customers really want and need a procedure before they make blanket decisions on coverage. This is a normal practice for any medical advancement. (8)

What to expect during the procedure

How many UroLift® implants will be required to treat my prostate successfully?

Each prostate is different and your physician won’t know the exact number of required implants until he/she examines your prostate, during the UroLift® System treatment. Typically between 4 and 6 implants are used, though it can be more for large prostates and fewer for smaller prostates. (1,2,3,14,15,16)

What if my Urologist needs to remove the implants?

The UroLift® implant is a permanent implant, and the treatment is intended to be permanent. Implants may need to be removed if improper placement occurs during the UroLift® System procedure. If needed, your physician can use small graspers to remove portions of the implant from your urethra and replace them with additional UroLift® implants during the same treatment. (1,14,16)

Will I be put to sleep?

During the procedure you may receive general anesthesia, if performed in the OR or light sedation, if performed in the office. Because of this, you will need someone to drive you home after the procedure.

What to expect after the procedure

What should I expect after UroLift® System treatment?

During the procedure you may receive general anesthesia, if performed in the OR or light sedation, if performed in the office. Because of this, you will need someone to drive you home after the procedure. You’ll want to refrain from strenuous activity for a week. Most patients report symptoms getting better within two weeks. You may have some mild discomfort for up to four weeks including pelvic ache, frequency (going to the toilet all the time) or urgency (the feeling that you have to urinate very badly). You will likely have some blood in your urine for a day or two, which could last a week or sometimes even a little more. If you have had a flexible cystoscopy before, it will feel similar to that procedure though the feelings will be a little stronger and may last a little longer. (1,14,15,16)

What are the side effects?

In the clinical studies to date, the most common adverse events reported included some blood in the urine, painful urination, urgency, pelvic ache, and possibly some urge incontinence – again these are typically gone by 4 weeks, and it may be sooner. By comparison most other BPH procedures can have permanent side effects including loss of ejaculation, incontinence, and erectile problems. Patients report returning to normal about 9 days after UroLift System treatment, on average. (1,3,9,10,11,12,13, 14)

Will UroLift® System treatment affect sexual function?

Sexual function has been preserved among the hundreds of patients treated in the clinical studies.(This is a unique benefit of the UroLift System treatment compared with other BPH therapies such as TURP, laser, and even medication. (1,2,3,5,14,15,16)

Do the metal components of the UroLift® devices cause problems with airport metal detectors?

No, they will not show up on the metal detector. (8)

Do the metal components of the UroLift® devices prevent having a later MRI?

A MRI can be safely performed after UroLift System treatment. The specific MRI instructions are provided by the manufacturer based on their testing.
Following your UroLift® System treatment, your Urologist, will give you a Patient ID Card. It is a good idea to carry it with you, because it describes the MRI information. You should show the ID Card to a doctor or technician who is performing an MRI.

What are the MR conditions (if asked by a doctor)?

A MRI can be safely performed when the MR system meets the following conditions:

  • Static magnetic field of 3 Tesla or less
  • Maximum spatial gradient magnetic field of 720 Gauss/cm (7.2 T/m) or less
  • Maximum MR system reported, whole body averaged specific absorption rate (SAR) of 4 W/kg (First Level Controlled Mode)
  • The technologist and Radiologist reading the MRI may notice an image artifact caused by the implant. (8)

If I have a prostate biopsy through my rectum, what happens when the biopsy needle hits one of the UroLift® implants?

Several patients have undergone a biopsy, following UroLift® System treatment without issue. The implants are on front side of the prostate, so having a biopsy should not be an issue. Also, it is unlikely that the small implants would interfere with a biopsy blade. (1,8,14,16)

I have read that many men don't need a catheter after they receive UroLift® implants. Is this true?

Many patients do not require a Catheter after an UroLift® System treatment. Your Urologist will determine this on a case-by-case basis after a void test. If you do get a catheter, it is typically only overnight; it comes out the next morning. (1,8,14,16)

I read that 5% of patients treated with the UroLift® System required retreatment over the first year. What are the factors that led to retreatment? (Note patient may also refer to this as “not effective for 5%”)

Lower urinary tract symptoms (LUTS) can be due to bladder issues or prostate issues. UroLift® implants open the urethra by “pulling back” the prostate, but sometimes the symptoms remain because the bladder doesn’t recover as much as with other patients. Your doctor will determine if UroLift System treatment is a good option for you. (1,14, 16)

On the UroLift® website, under the “Results Comparison” tab, TURP has better IPSS improvement results than patients treated with the UroLift® System. Why is that score higher for TURP?

In BPH, the prostate tissue is like a dam in the urinary System. UroLift® System treatment opens the dam, which is often enough of a change to improve your symptoms. TURP completely removes the inside of the prostate, so it removes the dam. It is the most effective way to remove the obstruction, but it can come with permanent side effects that have not been observed following UroLift® System treatment. (1,5,14,15)

How do the UroLift® implants affect a Digital Rectal Exam (DRE) exam?

Because the UroLift® implants are on the front side of the prostate, and a DRE is conducted on the back side of the prostate, the implants are not felt in a DRE. (1,14)

Future treatment options

Can I repeat UroLift® System treatment, if needed?

This has not been studied. If your symptoms return, your Urologist can evaluate you and see if repeating UroLift® System treatment is a good option. (1,14)

Can I have BPH surgery (TURP/PVP), if necessary, after UroLift® System treatment?

Yes. Both the traditional surgery, TURP, and laser surgery can be performed after UroLift® System treatment. (1,2,10,14,16)

References

1. Roehrborn et al., Journal of Urology 2013 LIFT Study
2. McNicholas et al., European Urology 2013
3. Chin et al., Urology 2012
4. Barkin et al., Canadian J of Urology 2012
5. Woo et al., J Sex Med 2012
6. Woo et al., BJU International 2011
7. Delongchamps et al., Progres en urologie 2012
8. Data on file at NeoTract
9. Oelke et al., Guidelines, EAU 2011
10. McVary KT et al., AUA Guideline for Management of BPH 2010
11. Roehrborn CG et al., AUA Guideline for Management of BPH 2003
12. Stucki et al., Abstract, AUA 2013 Meeting, San Diego
13. Elshalet al., Abstract, AUA 2013 Meeting, San Diego
14. Roehrborn CG et al., Urology Practice 2015 LIFT Study 2-Year Results
15. McVary, 2014 Journal of Sexual Medicine, Preservation of sexual function with the prostatic urethral lift
16. Roehrborn CG et al., AUA 2015 LIFT Study 3-Year Results, New OrleansSchedule Your Consultation

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