Prostatic Urethral Lift at Warwickshire Hospital

What is a prostatic urethral lift?

A prostatic urethral lift, also called PUL or UroLift, deals with an enlarged prostate by drawing the tissue blocking your urine flow away from the water pipe using small implants. Unlike several alternatives, nothing gets burned away or removed in the process.

What conditions does a prostatic urethral lift treat?

This procedure addresses benign prostatic hyperplasia, a harmless, non-cancerous condition where the gland grows larger than it should. Not everyone's suited to it though, so your urologist will check whether your own prostate's dimensions make you a workable candidate.

What are the benefits of a prostatic urethral lift?

• only a brief spell in hospital, given how minor the procedure genuinely is
• rarely calling for a catheter once it's over
• a notably low chance of sexual side effects such as retrograde ejaculation or difficulty with erections, unlike several rival ways of tackling gland enlargement
• brisk to carry out, generally wrapped up inside a quarter of an hour.

What are the alternatives to a prostatic urethral lift?

• conservative measures, cutting back on fluids or caffeine among them
• medication, either to shrink the gland itself or ease the surrounding muscles
• TURP or laser-based options, whether that means enucleation or vaporisation techniques, both clearing away the obstructing tissue rather than tugging it aside
• prostate artery embolisation, an approach handled by an X-ray specialist working outside the operating theatre
• Rezum steam ablation, relying on steam to shrink the gland over time.

Your urologist can advise on whether a prostatic urethral lift genuinely fits the size and shape of your own prostate.

What happens before a prostatic urethral lift?

Your urologist will go through your medical background and current medicines, checking you're ready to go ahead. Whoever is handling your anaesthetic will talk you through whether general or spinal suits you better, plus pain relief options for after the procedure.

You might be offered support stockings and a blood-thinning injection to help ward off clots. Flag any blood thinners you take, devices already fitted such as a pacemaker, or a previous MRSA infection to your medical team beforehand.

What happens during a prostatic urethral lift?

1. The procedure happens under general or local anaesthetic, whichever suits your circumstances best.
2. An antibiotic injection is typically given beforehand, checked against any known allergies first.
3. A scope travels through your water pipe and up into the bladder.
4. Several implants go into the gland via that same scope, pulling the tissue causing your blockage clear of the urethra.
5. A catheter generally isn't required once things wrap up.

The surgery takes roughly a quarter of an hour. Over the 3 months or so that follow, the implants gradually settle into your own prostate tissue and become indistinguishable from it.

What does recovery look like?

You're typically sent home that same day, once you've managed to pass urine without difficulty.

Some stinging and light bleeding when you pee tends to show up for the first handful of days, alongside pelvic soreness, which ordinary painkillers such as paracetamol generally settle. If getting urine out proves difficult afterwards, a temporary catheter might be considered to help for a short time.

These effects typically ease within a week and usually clear entirely within a month. Most people find themselves back to their usual routine within that same rough timeframe.

The DVLA only needs contacting where your driving ability looks set to be affected for longer than 3 months. It is worth checking with your insurer beforehand too, should that apply to you.

What are the risks and complications?

Possible risks linked to this procedure include:

• temporary stinging when you pee, running for around 5 to 7 days, affecting roughly 1 person in 3
• a small amount of blood appearing when you pee for a similar stretch, affecting roughly 1 in 4
• discomfort around the pelvis, affecting somewhere close to 1 in 5
• a sudden, pressing need to pee, affecting around 1 in 12
• temporary trouble holding urine in, affecting roughly 1 in 25
• difficulty passing urine altogether, needing a short-term catheter, affecting somewhere close to 1 in 20 to 30
• a urine infection calling for antibiotics, affecting a similar proportion, roughly 1 in 30
• stone-like build-up forming on the implants, occasionally needing removal later, affecting under 1 in 100
• the usual risks that come with any anaesthetic.

A meaningful minority, somewhere around 1 person in 8, discover their symptoms haven't fully cleared and go on to need something further done inside a 5-year window.