Surgical Procedures for Core Urology Trainees by Sanchia Goonewardene & Raj Persad

Author:Sanchia Goonewardene & Raj Persad
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

UroLift

UroLift is performed in a day case setting. The procedure involves using a rigid cystoscope to position an average of four implants (tensioned monofilament sutures, anchored with a metallic tab on the prostate capsule) which are placed under direct vision in the prostatic urethra. These sutures compress the enlarged prostate, open up the prostatic urethra and improve the patients symptoms.

As a guide, between two and four implants are generally used but this is dependent on the appearance during the procedure.

UroLift offers the advantage of being able to be performed in a day case setting, usually without any post-procedure catheter and there is no loss of erectile or ejaculatory function associated with the procedure.

Patients suitable for UroLift are those without an obstructing middle lobe and with a prostate volume of less than 100 ml. As part of the pre-operative evaluation, prospective patients should undergo transrectal ultrasound of the prostate to assess their prostate volume and flexible cystoscopy to assess the anatomy of the middle lobe.

The 5 year concluding data from the largest, longest, prospective, randomised study of the prostatic lift procedure (PUL) indicates that symptom relief and quality of life improvements can be durably sustained to 5 years. In addition sexual function is preserved in terms of erection and ejaculation.

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