The UroLift Procedure: Everything You Need to Know

The UroLift procedure is a minimally invasive treatment option for patients with lower urinary tract symptoms caused by benign prostatic hyperplasia (BPH)—the medical term for an enlarged prostate gland.

This procedure involves the insertion of tiny implants into a patient's urethra, the channel that carries urine from the bladder out through the penis. This is done with the UroLift System, a special delivery system approved by the U.S. Food and Drug Administration (FDA). The implants unblock the flow of urine from the patient's urethra by pushing excess prostate tissue out of the way.

Besides causing a rapid improvement in symptoms, the UroLift procedure has the added benefit of preserving sexual function. That said, for some patients who undergo this treatment, BPH symptoms eventually return.

What Is the UroLift Procedure?

The UroLift procedure takes less than an hour and is performed in a urologist's office under local anesthesia.

At the start of the procedure, the urologist inserts a special device into the patient's urethra. When the device reaches the prostate, it releases multiple small implants. Each implant is made of a nickel-titanium capsular tab and a stainless steel urethral tab that are held together by a polyester suture.

These implants "lift" or push away prostate tissue that is blocking the urethra. As a result, the urethra is widened, allowing urine to pass easily out of the body.

A unique advantage of the UroLift procedure is that, unlike medications and other surgeries used to treat BPH, it does not cause sexual side effects such as erectile or ejaculatory problems.

A disadvantage of the UroLift procedure is that while the implants are intended to be permanent, some patients develop recurrent symptoms, requiring a repeat procedure or another type of prostate surgery.

Besides a UroLift procedure, other minimally invasive procedures used to treat the symptoms of BPH include:

• Water vapor thermal therapy (Rezūm system): Uses energy stored in steam to remove prostate tissue
• Transurethral microwave thermotherapy: Uses heat to destroy prostate tissue

Contraindications

The UroLift procedure cannot be performed in patients with the following medical conditions/circumstances:

• A very large prostate gland (volume greater than 80 milliliters)
• An active urinary tract infection
• Visible blood in the urine (gross hematuria)
• A urethral condition that prevents insertion of the implant delivery system
• Urinary incontinence due to an incompetent sphincter

Potential Risks

The most common side effects associated with a UroLift are temporary and include:

• Discomfort when urinating
• Increased urinary frequency
• Inability to control the urge to urinate
• Pelvic pain
• Some blood in the urine

Rarely, significant bleeding and infection may occur.

Purpose

The purpose of the UroLift procedure is to treat lower urinary tract symptoms caused by BPH in men age 45 and older.

Symptoms of BPH occur as a result from an inability to fully empty the bladder because excess prostate tissue is slowing or blocking the flow of urine.

The symptoms most commonly experienced by men with BPH are:

• Urinating a lot, both during the day and night
• Experiencing a weak urine stream
• Leaking or dribbling urine

If the above symptoms develop, medication is usually tried first. Surgery is often considered if medication fails or if a patient cannot tolerate its side effects.

In the past, transurethral resection of the prostate (TURP) was considered the gold standard surgical treatment for BPH.

TURP entails removing pieces of the enlarged prostate gland using an electric current delivered through a wire loop. The surgery is done under general anesthesia, and most men stay overnight in the hospital afterward.

While effective, side effects of TURP include bleeding, urination problems, and erectile/ejaculatory dysfunction.

UroLift may be preferred because it is less invasive and does not affect sexual function.

How to Prepare

Once you are scheduled for a UroLift procedure, your doctor will give you instructions on how to prepare.

Location

A UroLift is performed by a urologist in their office. Plan to arrive around 30 to 60 minutes prior to your scheduled procedure time.

What to Wear

You will need to change into a hospital gown for your procedure. Therefore, it's best to wear clothes that are easy to remove.

Food and Drink

You may be advised to stop drinking alcohol and any caffeinated beverages, including coffee, starting two days before your procedure.

After midnight the evening before your UroLift, avoid eating or drinking entirely. One exception: You can take your usual medications with a small sip of water.

Medications

If you take aspirin or another type of blood thinner, your doctor might ask you to stop a week before your procedure.

Be sure to tell your doctor all of the drugs you are taking, including prescription and over-the-counter medications, herbal products, vitamins, and recreational drugs.

What to Bring

On the day of your procedure, bring your driver's license and insurance card.

Arrange to have someone drive you home afterward.

What to Expect on the Day of the Procedure

While a UroLift is a relatively fast procedure, it's normal to feel apprehensive going into it. Knowing what to expect from start to finish will hopefully help ease your mind a bit.

Before the Procedure

Upon arrival at your doctor's office for a UroLift, you will be escorted to the exam room where you will be asked to undress from the waist down and put on a gown.

Your urologist will then likely come to greet you and briefly review the steps of the procedure with you. You may need to sign a consent form at this time.

Next, a nurse will ask you to lie back on the exam table. You will be given a mild sedative, such as Valium (diazepam), to help you relax before the local anesthesia is administered.

During the Procedure

When it's time to begin the procedure, you will lie on your back with your knees bent and your legs supported by padded footrests attached to the table.

Your urologist will then proceed with the following steps:

• Anesthesia administration: A catheter will be placed in your bladder to drain urine and inject a chilled liquid numbing medication called lidocaine. Lidocaine gel will also be used to numb your urethra. The catheter will then be removed, and your penis will be clamped for a 20 minute period with an external device that applies gentle pressure.
• Visualization: The urologist will insert a thin, surgical instrument with a small camera attached to it (called a cystoscope) through your urethra until it reaches your bladder.
• UroLift delivery device placement: Once the cystoscope is in your bladder, part of it will be replaced with the UroLift delivery device. This device is rotated and moved such that the excess prostate tissue is accessed and compressed. During this time, you may feel some mild pressure or an urge to urinate.
• Implant delivery: Two to six small implants will be delivered through a small needle that comes out of the UroLift delivery device and into the prostate. You may hear a "click" when the implant is being delivered.
• Device removal: The UroLift delivery device will be removed and you will be assisted up from and off of the table.

After the Procedure

After the procedure is over, you will be asked to use the bathroom to urinate. You may notice some burning at the tip of your penis or a stinging sensation when you urinate. This is normal as the lidocaine is starting to wear off, and your urethra is a bit sore from the procedure.

Once you urinate, you will get dressed and be sent home to recover.

If you are having trouble urinating after the procedure, your doctor may insert another catheter in your bladder. Some patients go home with this catheter to help them void and have it removed at a follow-up visit.

After you discuss any questions or concerns that you have about your procedure or recovery, you will get dressed and leave your urologist's office.

Recovery

As you recover at home you may experience some achiness in your lower abdomen/pelvis and mild discomfort when sitting.

You may also notice that you have to urinate more frequently and that you have some blood in your urine.

All of this is normal and should resolve within two to four weeks.

During this time, it's important to follow your doctor's post-operative instructions, which may include:

• Take your pain medication—typically a nonsteroidal anti-inflammatory drug (NSAID), like Motrin (ibuprofen)—as needed.
• Continue and finish your antibiotic as prescribed. 
• Stay hydrated by drinking 1.5 to 2 liters of water throughout the day.
• Avoid drinks and foods that may irritate your bladder (e.g., caffeine, alcohol, or spicy/greasy foods).
• If you had a catheter placed after your surgery to help you urinate, see your doctor or their nurse (usually one to three days later) in order to have it removed.

Be sure to confirm post-operative activity restrictions with your doctor. Some doctors recommend a week of lighter activity and avoiding sex for a week. Others say it's OK to resume normal activities within a day or two after the UroLift, assuming you are feeling up to it.

Your first follow-up visit will be around two weeks after your procedure. At this appointment, your doctor will monitor you for complications, ensure you are able to empty your bladder appropriately, and review improvements in your BPH symptoms.

Long-Term Care

Research has found that the UroLift procedure offers a rapid improvement in BPH symptoms—close to 90% greater when compared to a sham procedure—and an improvement in patients' quality of life.

That said, it may take around three months to see the full results of your UroLift procedure, which is why it's important to attend all of your follow-up appointments.

After your first post-operative appointment, you can expect to see your surgeon at one, three, and six months after the procedure. These are usually followed by annual visits.

Possible Future Surgeries

A repeat UroLift or additional prostate surgery may be needed in patients whose BPH symptoms recur.

In one study that examined patients over a five-year period after undergoing a UroLift, close to 14% of patients needed surgical retreatment.

A Word From Verywell

The UroLift procedure is a unique treatment approach that accomplishes symptom relief and an improvement in quality of life without troubling sexual side effects. That said, the procedure may not be right or permanent for everyone.

If you are experiencing symptoms of BPH and not getting relief with medication, or are bothered by its side effects, it's reasonable to talk with a urologist about possible surgical options.

Keep in mind that urologists may be specially trained in certain procedures. As such, you may want to seek out more than one opinion before making a final decision.