A Modern Solution for Prostate Enlargement

Changes in urinary habits are common as men age and can significantly affect daily life. One of the most frequent causes is prostate enlargement, clinically known as benign prostatic hyperplasia (BPH). Typically developing after the age of 50, BPH involves non-malignant growth of prostate tissue that can interfere with normal urine flow. For some patients, alternatives to long-term medication or invasive surgery, such as the UroLift procedure, may be considered.

What Is Prostate Enlargement (BPH)?

Benign prostatic hyperplasia (BPH) occurs when there is an overgrowth of tissue in the prostate’s transition zone, which is the area surrounding the urethra. As this tissue enlarges, it can form lobes that press into the urinary channel, narrowing the passage for urine. This forces the bladder to work harder to empty and over time, the resulting obstruction can have a noticeable impact on quality of life.

Common signs of BPH involve changes in urinary flow and bladder emptying, such as:

• A weak or interrupted urine stream
• Difficulty starting urination
• Frequent urination, especially at night (nocturia)
• A sudden and urgent need to urinate
• Straining or effort required to empty the bladder fully

What Is the UroLift® System and How Does It Benefit BPH?

The UroLift system is a minimally invasive treatment option for BPH. It is classified as a mechanical, suture-based procedure and does not involve cutting, heating, or removing prostate tissue, unlike some surgical approaches.

The procedure is typically performed by a urologist in an outpatient setting. Rather than excising tissue, the UroLift system works by mechanically retracting the enlarged lateral lobes of the prostate, reducing compression of the urethra, and improving urinary flow.

A specialised delivery device is inserted through the urethra to access the prostate. This allows the clinician to identify areas contributing to obstruction. Small permanent implants are then placed to hold the enlarged tissue away from the urethra, creating a wider channel for urine to pass.

The number of implants used varies between patients and is determined by prostate size and anatomy. Most procedures involve between two and six implants, although some individuals may require more.

Who Should Consider UroLift®?

The UroLift® System is generally recommended for men seeking an effective alternative to chronic medication or more invasive surgery.

Typically, ideal candidates:

• Have BPH-related lower urinary tract symptoms that are moderate to severe.
• Are deemed suitable based on their overall health and prostate anatomy (typically prostate volume between 30 cc and 80 cc).
• Are seeking a treatment that definitively preserves erectile and ejaculatory function.
• Want an intervention that avoids the need for cutting or removal of prostate tissue.

Suitability is ultimately determined by the consulting clinician following a comprehensive assessment that weighs clinical necessity against patient preference.

Assessment Before UroLift®

Before proceeding with UroLift, a clinical evaluation is performed to confirm BPH as the cause of symptoms and ensure treatment appropriateness.

• Medical History and Symptom Review: This involves a detailed discussion about the patient’s health, the trajectory of their urinary symptoms and current medications.
• Physical Examination: A digital rectal examination (DRE) is performed to estimate the size, shape and consistency of the prostate gland.
• Laboratory Tests: Blood and urine samples are taken to rule out infection or kidney impairment. PSA testing (Prostate-Specific Antigen) may also be performed to screen for prostate cancer risk.
• Imaging and Functional Tests: Procedures such as prostate ultrasound are carried out to accurately determine prostate size and evaluate the anatomy.
• Cystoscopy: This internal visual inspection of the urethra and bladder confirms the degree and nature of the prostate's obstruction.

Recovery After UroLift®

The recovery period is notably quicker than with traditional surgery. Patients may experience temporary side effects in the first few weeks, such as a mild increase in urinary frequency, urgency, or discomfort during urination. These effects are generally mild and diminish rapidly.

It is recommended that patients avoid strenuous physical activity for a few days and refrain from sexual activity for a brief period, as advised by their surgeon. A critical follow-up is scheduled to monitor symptom improvement. Patients must seek immediate medical attention if they notice a fever or significant difficulty passing urine.

UroLift® Compared with Other BPH Treatment Approaches

UroLift sits between medication and more invasive surgical procedures. Medicines are often the first line of treatment, but they usually need to be taken long term and may cause side effects that affect the whole body. On the other hand, surgical procedures such as a Transurethral Resection of the Prostate (TURP) remove or reduce prostate tissue and can provide lasting relief. However, they carry a higher risk of complications.

UroLift offers a different approach by relieving blockage through mechanical support rather than tissue removal. This enables symptom improvement while preserving sexual function, with a lower risk of certain complications compared with tissue-removing surgery, although some patients may require additional treatment over time.

When to Seek Medical Advice

Persistent or worsening lower urinary tract symptoms should never be ignored. Patients should consider consulting a specialist if they experience symptoms such as a severely reduced stream, incomplete emptying, blood in the urine or frequent night time urination.

Early specialist evaluation is essential to establish the correct diagnosis, ensuring the symptoms are due to BPH and not other critical underlying conditions such as bladder stones or prostate cancer.

Discussing UroLift to Manage BPH with Urology Practice

An informed decision involves understanding how UroLift compares with other BPH treatment options, as well as what to expect before, during and after the procedure. Discussing potential benefits, limitations and possible side effects with a specialist helps ensure realistic expectations and long-term satisfaction with the chosen treatment.

At Urology Practice, we strive to help patients navigate their conditions with clarity and regain their confidence. Leading the team is Dr Jonathan Teo, a consultant urologist with subspecialty expertise in men’s health and known for his patient-centred approach. If you would like to explore your options for managing prostate enlargement, or are considering UroLift as a potential treatment choice, get in touch with us for an accurate assessment today.