The UroLift® System treatment is a minimally invasive approach to treating an enlarged prostate (BPH) that uses small titanium clips to gently lift and compress the prostate tissue out of the way so it no longer blocks the urethra urinary channel.
The procedure avoids cutting, heating or removal of prostate tissue. Thus, the risks of erectile problems (impotence), ejaculatory problems (retrograde ejaculation), or permanent urinary incontinence are therefore reduced.
UroLift is a good option for many patients with an enlarged prostate gland causing obstruction to the flow of urine. Patients who do not wish to be taking daily pills, cannot tolerate medications are great candidates for the procedure. This is also a great choice for patients who wish to preserve their ejaculation as the traditional surgical methods do decrease the amount of semen that is expelled with orgasm.
Most procedures are straightforward; however as with any surgical procedure there is a chance of side effects or complications. Most of these side effects are often mild and short-lasting (4-6 weeks)
Common Side Effects:
The UroLift procedure is usually performed as day surgery (go home the same day). In some cases, the UroLift may be done at the office under local anesthesia or deep sedation at a surgical center or hospital.
The operation involves passing a camera up the penis and placing small, metal clips into the prostate to lift and hold the enlarged tissue out of the way and allowing urine to flow. Most men do not need a catheter (penis tube to drain the bladder) after the procedure unless their prostate is large in which case a temporary catheter may be placed overnight.
The Urolift is a minimally invasive safe treatment for urinary symptoms caused by an enlarged prostate gland. However, it may not be suitable for every case. The alternative options include:
Where Is the UroLift procedure done?
The procedure is performed in the office, surgical center or hospital procedure room.
Will I Be Asleep for This Surgery?
The UroLift procedure may be done under local anesthetic that is injected via small rectal probe just before the procedure. Some patients elect to have this done under deep sedation or general anesthesia but that must be done at either a surgical center or hospital procedure room with anesthesia doctor supervision.
How Long Does the Procedure Take?
The amount of time the surgery takes depends on the size of the prostate but typically 15-30 minutes is required to complete the procedure.
Will I be staying in the hospital or going home?
Most patients are able to go home the same day of the procedure.
Getting Ready for Your Operation
If you smoke, try and cut down or preferably stop, as this reduces the risks of heart and lung complications during and after the procedure if it is done under deep sedation or general anesthesia.
If you do not exercise regularly, try and do so for at least half an hour per day e.g. brisk walk or swimming. This will help both with anesthesia and with overall recovery.
You are required to visit your primary care doctor for “clearance” for the procedure. Typically, this is a general checkup that includes checking your heart, lungs, blood work, EKG, chest x-ray and any other necessary tests to ensure that you are fit and ready for surgery. Your primary doctor will notify you if you need to see any other specialists such as a cardiologist or pulmonologist to make sure that you are ready for the procedure.
Tell the doctor if you:
Morning of the procedure, we would like for you to do an enema with any over the counter product like a Fleets enema or a saline enema to clear out the rectum.
If the procedure is done in the office, the typical course of the procedure is as follows:
If done in the office, once the procedure is complete and you do not have a catheter, you will be a given a chance to urinate and may pass some blood with urination. This is expected. If you are not able to urinate, we may need to place a temporary catheter tube in the penis to allow the swelling to calm down and remove the catheter in a day or two.
If the procedure was done in the hospital or surgical center, then after your operation, you will be placed in the recovery area. You may start eating and drinking as soon as you recover from the anesthetic. The nurses will provide any pain medicines, will monitor your breathing and vital signs. You may not remember any conversations or your time in the recovery area. Once the nurses and anesthesia staff have cleared you to go home, you will be provided follow up information. You will be a given a chance to urinate, but if having difficulty, a penis catheter may be placed by the nurse and kept for a day or two to allow the swelling to calm down an let you urinate better.
If you had deep sedation or general anesthesia, you MUST arrange for a ride home.
Rarely, a patient after the UroLift procedure may require a catheter to drain the bladder temporarily. A urinary catheter is a tube that runs from the bladder out through the tip of the penis and drains into a bag. It is important to drain the urine in this way until the urine is clear. Your catheter is usually removed 1-3 days after your operation. Avoid pulling on the catheter as this may provoke bleeding. It is common for urine to occasionally squirt around he catheter at the tip of the penis. It is also very common to have a bit of blood dripping around the catheter at the tip of the penis.
We advise putting a small amount of antibiotic ointment such as Neosporin or Bacitracin or simply some Vaseline at the tip of the penis several times per day to allow the catheter to glide smoothly.
Call our office or stop by if all the urine is coming around the catheter and none is draining into the urinary drainage bag. You and your family/friends will be given instructions on the catheter care.
It is quite normal to see an occasional show of blood in your urine during the first month after surgery – this is due to the healing of the operation site. It is common to have more bleeding if you strain to have a bowel movement. If you see blood, simply increase your fluid intake. If you have prolonged heavy bleeding (>24 hours), significant pain or increasing difficulty passing urine, please contact the our office.
Because there are no external cuts, this procedure is relatively pain free. You may experience some discomfort from the catheter, but this is usually easily treated with mild painkillers. Tylenol may be used for pain. However, we will provide you with a prescription for a stronger pain killer should you need one. Beware, stronger pain killers may cause constipation.
It is important that you do not get constipated. There are no dietary restrictions but you should try and eat plenty high fiber food or anything that would get your bowels moving. You may use milk of magnesia or an enema if you get severely constipated. If you have chronic constipation, you may be provided with a stool softener as one of the prescriptions after the procedure to prevent constipation. The reason to avoid constipation is that straining to have a bowel movement tends to increase the risk of bleeding from the prostate.
There are no restrictions on taking showers even with the catheter in the penis. Staying and keeping yourself clean is always important. Please do NOT take baths, go into the pool or ocean with the catheter in place.
You should take it easy for a month, although it is important to do some gentle exercise like walking, to reduce the risk of developing a blood clot in your legs. Try to avoid any activity that makes you strain as this will increase your chances of bleeding from the prostate. You can resume normal sexual activity 2 weeks after your operation.
Recovery may take several weeks. However, most patients feel well within a few days to a few weeks. We will be able to advise you when it will be safe to return to work as this depends on your occupation. Most patients with a sedentary office job require about a week of recovery, but those who do a lot of straining and lifting, may need several weeks before they are clear to go back to work. We can provide you with an excuse from work an any other paperwork for your job at our offices.
You may resume driving a motor vehicle you feel well and do not have significant pain or discomfort. You are absolutely not allowed to drive or operate any other motorized device while on narcotic pain killers.
For Further Information
This information is intended as a general educational guide and may not apply to your situation. You must not rely on this information as an alternative to consultation with your urologist or other health professional. Not all potential benefits or complications are listed, and you must talk to your urologist about the best treatments specific to your situation.