Short- and Medium-Term Outcomes Assessment of Urethral Prostatic Lift (UroLift) as a Minimally Invasive Treatment for Benign Prostatic Hyperplasia in a Tertiary Care Centre.

INTRODUCTION AND AIM

Benign prostatic hyperplasia (BPH) is the enlargement and overgrowth of the prostate leading to the compression of the urethra and resulting in obstruction to the outflow of urine. Prostatic urethral lift (UroLift) is a budding minimally invasive technique that utilises mechanical manipulation of the prostate tissue so that the urethra is free from compression, thereby creating a channel for the outflow of urine. The aim of the audit was to assess the short- to medium-term outcomes in our centre in terms of improvement in symptoms, quality of life (QoL) and complication rates.

METHOD

A retrospective observational study was employed. All patients who had UroLift procedure between December 2021 and December 2022 were included.

RESULTS

Sixty-four patients were found for the chosen period. Age ranged between 48 and 91 with a mean age of 73. The average prostate size was 48.63 g (31-50 g). Of the patients, 64% (n=41) had the procedure performed under general anaesthesia, whilst the rest had either regional or local anaesthesia or entonox. Two to eight clips were used per patient, with four being the median number of clips. Furthermore, 53.13% (n=34) had a catheter post-procedure, with 52.94% (n=18) of these achieving trial without catheter (TWOC) in less than seven days. Of the patients, 67.18% (n=43) had no complications, 7.8% (n=5) went into acute urinary retention requiring short-term catheterisation, 1.56% (n=1) had bleeding requiring blood transfusion and 6.25% (n=4) had infection. Overall, 17.18% (n=11) had failure of procedure requiring other forms of intervention for BPH at two years post-operatively. The median improvement in post-void residual scan and quality of life (QoL) scores were 58 mL and 1.5, respectively.

CONCLUSION

Although transurethral resection of the prostate (TURP) remains the gold standard surgical treatment for BPH, UroLift offers a less minimally invasive approach with better short-term recovery, preservation of sexual function and low complication profile. The failure rate from UroLift from previous studies falls within the range of 7%-22%, and the figures attained in our centre are comparable to these.