UroLift (Prostatic Urethral Lift)

Each implant is a small device with a permanent monofilament suture running between a nitinol anchor, which is deployed on the outer surface of the prostate capsule, and a stainless steel end piece that sits in the wall of the urethra. When the suture is tensioned, the lobe of the prostate is drawn sideways and held there, widening the channel through which urine flows. Two to six implants are usually placed, depending on the length and shape of the prostate, and they remain in place permanently. Because they simply hold tissue aside, the prostate is not damaged, no raw surface is created and no tissue has to slough or be reabsorbed. This is the mechanism that distinguishes UroLift from resection, laser enucleation and the energy-based treatments such as steam therapy.

The urologist passes a slim delivery device along the urethra under direct vision until the enlarged part of the prostate is reached. The device is angled towards one lobe, a fine needle is advanced through the prostate tissue and out through its capsule, and the anchor is deployed on the outer surface. As the needle withdraws, the suture is tensioned and the urethral end tab is locked in place, drawing the lobe outward. The excess suture is cut automatically. The step is repeated on the opposite side and, if the prostate is long, at a second level, so that the channel is held open along its length. The urologist inspects the result endoscopically before withdrawing the instrument. Most procedures take about 10 to 20 minutes, and many men leave without a catheter or with one for only a short period.

The treatment addresses lower urinary tract symptoms caused by benign prostatic enlargement: a weak or interrupted stream, difficulty starting, a feeling of incomplete emptying, urgency, frequency and getting up at night. It suits men whose symptoms are bothersome despite medication, or who prefer not to take long-term medicines because of side effects such as dizziness or sexual dysfunction. It is particularly relevant for men who place a high value on preserving normal ejaculation, and for those in whom general anaesthesia is best avoided. It is generally recommended for prostates of small to moderate size, roughly up to 80 millilitres, with lateral lobe enlargement. A very large gland, prostate cancer, an active urinary infection or a bladder that no longer contracts are reasons to choose a different treatment, while a prominent middle lobe protruding into the bladder may need a specific implant technique or a different treatment; a urologist assesses this with a flow study, an ultrasound measurement of residual urine, prostate imaging and a cystoscopy.

The main benefits are speed of recovery and preservation of sexual function. Published studies and long-term follow-up report meaningful improvement in symptom scores and flow rate, with no new cases of retrograde ejaculation or erectile dysfunction attributable to the implants, which is unusual among prostate procedures. Most men notice improvement within about two weeks, and many avoid a catheter entirely. In the first days there is commonly some burning on passing urine, urgency, a need to go frequently and a trace of blood in the urine, all of which usually settle within one to two weeks. Antibiotics may be given around the procedure. Because no tissue is removed, the prostate continues to grow slowly over the years, so a proportion of men eventually need a further procedure, and the implants do not prevent later surgery if it becomes necessary. Magnetic resonance imaging is not restricted by the implants under normal conditions, and a device card is provided.