UroLift: A New Solution for Enlarged Prostate


 
Timothy C. Goodson, MD

One of the most prevalent conditions men face as they age is the enlargement of their prostate, or what is often called benign prostatic hyperplasia (BPH). BPH affects a third of men older than 50, as many as 7 in 10 men in their 60s, and 9 in 10 men who are 85 years old, or older.

The prostate is a muscular gland that sits between the bladder and the penis, in front of the rectum, and wraps around the urethra. As a chronic condition, BPH is one of the least morbid, most frustrating and uncomfortable (nevermind untreated) diagnoses in medicine, and results from the natural proliferation of epithelial and muscle cells within the gland.

This might not spell trouble if the prostate sat apart, but it doesn't. As it grows, it hugs, even pinches, the urethra. Today, there's a revolutionary new treatment called UroLift that's growing in number and recommendation. It's non-surgical, as minimally invasive as an internal procedure can be, and makes no physical change to the gland through cutting or lasers.

It's helping a growing number of Arkansas men. BPH precipitates a variety of conditions around the act of micturition, from discomfiting (a weak stream or dribbling at the end of urinating) to alarming (starting and stopping, the sensation that your bladder is full despite having just emptied). If BPH continues unabated, the urethra will be pinched nearly closed, obstructing flow and inspiring the most severe lower urinary tract symptoms (LUTS).

As with all conditions, early intervention is key. While BPH is a top reason that patients are referred to a urologist, only about one-third of patients with BPH actually seek help. Naturally, there are some issues that men are reluctant to talk about. It's imperative to ask the right questions of patients to let them know something can be done and get a diagnosis.

The good news for patients is that the UroLift System offers immediate relief. UroLift can even be the first line treatment for patients. It's deployed by a thin guide that travels gently up the urethra to the prostate (under general or local anesthetic, and with the help of cystoscopic visualization). The device implants a suture with a Nitinol tab, a shape memory alloy of nickel and titanium that's used in stents (and nontoxic, of course). These implants pin the obstructing lobes back, pinching the prostatic bulge at the point of contact with the urethra, relieving the bottleneck. Typically, two to three implants are made against each wall. The procedure is performed in under an hour. This is a one-time procedure for patients, no ongoing medications or long-term therapy.

The UroLift System doesn't reverse the hyperplasia (or hypertrophy) or turn back the clock, and because it is a material stent, it is not without side effects including discomfort and the evidence of light bleeding during micturition immediately following the procedure, but these subside within a very short time.

The advantages, meanwhile, are many:

  • 100 percent effective relief immediately of the most common lower urinary tract symptoms caused by BPH
  • Minimally invasive with no cutting, heating or removing of prostatic tissue
  • Performed by a urologist in a clinical, not surgical, setting
  • Patients return home without a catheter or other aid
  • No subsequent pharmaceutical regimen
  • No sexual side effects such as erectile dysfunction or retrograde ejaculation

The UroLift System might not be right for every man in every case. Many urologists may justifiably advise a course of alpha blockers for BPH, which relax the muscles of the prostate, or 5-alpha reductase inhibitors (5-ARIs), which may shrink the actual tissue. Men with very enlarged prostates may be advised to have surgery, up to and including a prostatectomy, or receive a combination of drugs.

All of these alternatives may carry significant side effects and are not without complications. The UroLift System carries no long-term side effects, and better still, it can be done first, or in conjunction, with other therapies. Patients are able to return to normal activities within one to two weeks. Most of them are able to discontinue medications. There is no new sustained erectile dysfunction and the patients have long-term symptom relief. Also, research shows that even five years out less than five percent of patients will need other therapies.

At Arkansas Urology, we can help patients and we are happy to talk more about this revolutionary procedure as an option for your BPH patients.


Timothy C. Goodson, MD, is a past president of the Arkansas Urologic Society and a member of the American Urological Association. He currently serves on the medical advisory board of the Arkansas Prostate Cancer Foundation and has been instrumental in bringing new prostate cancer treatments to the central Arkansas area.

Arkansas Urology is the largest specialty of its kind in Arkansas. To learn more, visit http://www.arkansasurology.com

 
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