Name of the Procedure:

Cystourethroscopy with insertion of transprostatic implant; 1 to 3 implants (C9739)

• Common names: UroLift System, Prostate Lift
• Medical terms: Transurethral incision of the prostate, Prostatic urethral lift

Summary

Cystourethroscopy with insertion of transprostatic implant is a minimally invasive procedure designed to treat urinary problems caused by an enlarged prostate. Small implants are inserted into the prostate to hold it open, alleviating symptoms without the need for more invasive surgery.

Purpose

• Medical conditions: Benign Prostatic Hyperplasia (BPH), urinary retention, frequent urination, weak urine flow
• Goals: Reduce urinary symptoms, improve quality of life, avoid the side effects associated with traditional prostate surgery

Indications

• Symptoms: Difficulty urinating, frequent urination (especially at night), weak urine stream, feeling of incomplete bladder emptying
• Patient criteria: Males with symptomatic BPH, typically failing conservative management like medication

Preparation

• Instructions: Usually includes fasting for 8 hours prior, stopping certain medications (e.g., blood thinners), arranging for transportation home
• Tests: Pre-procedure evaluation including a physical exam, blood tests, urine tests, and imaging studies like ultrasound or MRI

Procedure Description

• Step-by-step: The patient is positioned, and local anesthesia or mild sedation is administered. A cystoscope (a thin, flexible tube with a camera) is inserted through the urethra to reach the prostate. Using the cystoscope, the physician places 1 to 3 small implants into the prostate to hold it open, relieving pressure on the urethra.
• Tools and equipment: Cystoscope, UroLift delivery device, transprostatic implants
• Anesthesia: Local anesthesia or mild sedation

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

Performed in a hospital, outpatient clinic, or specialized surgical center.

Personnel

• Urologist or surgeon
• Nursing staff
• Anesthesiologist or sedation nurse (if applicable)

Risks and Complications

• Common: Mild discomfort, temporary urinary urgency or frequency, slight bleeding
• Rare: Infection, implant migration, prolonged urinary symptoms, injury to the bladder or urethra

Benefits

• Expected benefits: Rapid symptom relief, increased urinary flow, improved quality of life
• Timeline: Benefits are often realized within a few weeks after the procedure

Recovery

• Post-procedure care: Patients can often go home the same day, avoid strenuous activity for a few days, drink plenty of fluids
• Recovery time: Most patients return to normal activities within a few days, with full recovery within 1 to 2 weeks
• Instructions: Follow-up appointments to monitor progress, medication for pain management if necessary

Alternatives

• Other options: Medication (alpha-blockers, 5-alpha reductase inhibitors), traditional surgery (TURP), laser therapy, watchful waiting
• Comparison: UroLift is less invasive, has a quicker recovery time, fewer sexual side effects compared to traditional surgeries, but may not be suitable for very large prostates

Patient Experience

• During procedure: Mild discomfort, pressure sensation; sedation or local anesthesia helps manage pain
• After procedure: Mild to moderate discomfort, urinary urgency or frequency, manage with pain relief medications, limited activity for a few days