Urolift Procedure BPH
The Urinary System
The urinary system begins with the kidneys, which make urine that runs through tubes down to the bladder. The bladder’s job is to store urine until full, then empty to the outside through the urethra, which is the road to the outside.
The prostate is the first part of the road. When men are 20, the road is wide open. When men reach the age of 40, the road begins to get blocked as the prostate enlarges. The prostate enlarges in most men (known as benign prostatic hyperplasia, or BPH).
If the enlarged prostate is not causing symptoms, it can be left as is. If the prostate enlarges and “blocks the road”, causing urinary bother, then an effort can be made to help lessen the burden associated with the change in urination.
When deciding what type of treatment should be used to help lessen the bother associated with the urinary changes, it is useful to look at the benefits and burdens of each of the different treatment avenues. Pills are often used as the first choice. In broad terms, there are two types of medication. The first type, the alpha blockers, open the road by relaxing the outer grip of the prostate. The second type, Proscar (finasteride) and Avodart (dutasteride), reduce the size of the enlargement, and can lead to less blockage after a period, usually 6 to 12 months. For some men, medications do not provide enough relief. For other men, they do not like having to take pills on an ongoing basis. If medications are not the answer, there are different techniques available to open the blocked road.
The most commonly used techniques, greenlight laser and TURP, are very effective ways to “plow the road open” to relieve the obstruction. These procedures require a general anesthetic, and a catheter that stays in for 2 to 3 days after the procedure. Both of those procedures can cause retrograde ejaculation, also known as dry climax. In that circumstance, semen is still produced, but at the time of climax, it back washes up into the bladder, rather than coming out the tip of the penis with ejaculation.
New techniques, known as minimally invasive procedures seek to provide a less invasive way to open the “blocked road”. From the patient standpoint, a successful technique is one that it is easy to tolerate, improves urinary symptoms, allows a quick return to normal activities, poses minimal hazards that can occur as a result of treatment and one that can be done at a manageable cost.
The goal of these techniques remains the same – address the blocking part of the prostate, open the urinary pathway, and allow improved urinary flow.
The urolift implant is placed using the cystoscope, the fiberoptic catheter used to look in the urethra and the bladder. The procedure, done with IV sedation, does not require a full general anesthesia.
The Advantages of the Urolift Procedure
The advantages of the urolift procedure are that it may allow one to stop taking pills for the enlarged prostate, it can avoid the potential hazards that may occur with one of the more invasive procedures, and it typically does not require an overnight stay. Most men do not require a catheter after the procedure. Sexual function remains the same, and ejaculation is usually preserved.
Again, a useful format to understand the approach to the enlarged prostate, is to be aware of the different tools which are available to help, and to view those tools in the context of potential benefits and burdens. The ideal outcome is to find the treatment avenue that offers the most benefit while minimizing potential burdens.
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