The UroLift System: A True Gamechanger for the Treatment of Enlarged Prostate (BPH)
Dr. R. Robert Dhir is a board-certified Urological Surgeon who sees patients in the Clear Lake area of Houston, TX. He earned his undergraduate and medical degrees from Georgetown University and was awarded honors in pre-medical studies, urology, orthopedics, and ophthalmology during tenure in Washington, DC. Dr. Dhir served... more
Benign prostatic hyperplasia, or enlarged prostate, has undergone a paradigm shift in the last several years thanks to the adoption of The UroLift System. For decades, patients were treated with daily medications filled with harmful side effects like sexual dysfunction and dizziness just to allow them to empty their bladder and maximize uninterrupted sleep at night.
When medications failed, or side effects mounted, the next step was the ‘roto-rooter’, or TURP procedure. TURP stands for transurethral resection of the prostate, which is an invasive surgery requiring overnight hospitalization to remove blocked prostate tissue. Removal of this tissue allows one to urinate with a strong stream and minimize frequent trips to the bathroom.
The problem with TURP is that the recovery is 6 weeks of no real physical activity, all while urinary symptoms worsen during this time period before these symptoms improve. Burning with urination, blood in urine, and incontinence all are included in this recovery period which can be difficult for most men. In addition, erectile dysfunction is a 10-20% risk from this procedure. It is the main reason most men do not opt to undergo surgery for BPH.
It is no wonder why only a small percentage of men opt for TURP every year given its risks and prolonged recovery time. Most men either deal with expensive medications that do not treat their symptoms, or they simply give up, stop medications, and suffer through bothersome urinary symptoms for the duration of their lifetime. This latter scenario could lead them to have complete bladder failure and become dependent on a urinary catheter, or tube, to drain their bladder longterm.
Fortunately, The UroLift System was developed as a quick 10-minute office procedure as an equivalent alternative to TURP. After UroLift, all medications for the prostate are stopped, the patient goes home the same day, and the recovery period is only a few days of urinary symptoms followed by a significant improvement in bladder health. Bleeding is minimal and there are no physical restrictions afterward – a true gamechanger!
What is Bladder Health?
The bladder is like any other muscle in the body. It squeezes to drain urine when we urinate. If the prostate is enlarged and blocking urine flow, the bladder muscle over time will thicken, or hypertrophy. The consequences of this are a decreased ability to hold urine and the inability for the bladder muscle to mount sufficient pressure to completely empty. This leads to the well-known BPH symptoms of weak stream, urgency, and frequency of urination that typically will worsen as men age.
My analogy for bladder health is that the bladder is like a pump, and if this pump is straining for years it will eventually give out. We want to remove the obstruction before the pump, or your bladder permanently deteriorates. If BPH is left unaddressed, the bladder can fail and a catheter will be needed to drain urine. There is a reason there are so many catheter commercials on late-night TV: BPH affects most men and often these symptoms are being ignored.
Medications may offer some symptom relief, but it is not relieving the strain on the bladder. Bladder health is still deteriorating since the obstruction has not been treated. Medications, to use the previous analogy, are acting like Drano. They are a temporary measure but not the solution.
The UroLift System Preserves and Improves Bladder Health
The UroLift System has been performed for over 15 years, but recently in 2018, the American Urological Association (AUA) added this procedure as an effective option in its BPH Surgical Management Guidelines. I consider myself fairly conservative in adopting new technology as patient safety is of the utmost importance. Once the UroLift System became validated by the AUA, based on their extensive research and experience with the technology, I began to perfect my technique.
I have performed roughly 100 UroLifts with great results. In the past, the majority of my surgeries for BPH were TURPs or Plasma Button Vaporizations. Now, the amount of TURPs I perform has dramatically reduced in favor of UroLift. Why? Because UroLift combines the strong outcomes of TURP, minimizes recovery time, and eliminates the threat of sexual side effects. It also takes about 10 minutes in comparison with the other procedures that take 1-2 hours under general anesthesia. UroLift is the first real gamechanger I have encountered in urology.
The UroLift System can be performed in the office or under twilight sedation in the hospital or surgery center. Developed by MIT engineers, it uses small implants to push the blocked prostate tissue away from the urinary channel in very short procedure time. What is remarkable is that there is usually no need for a urinary catheter, no significant bleeding, no post-operative pain, and the recovery time is measured in days not weeks.
When faced with a decision to either ignore the symptoms, take medications, or fix the issue, my answer would personally to be treat BPH with The UroLift System. All things equal, it is the quickest and most effective solution with the least amount of postoperative complications, and most importantly no sexual side effects.
