The Urolift procedure; patient views and questions

I think I waited about 3 weeks before I started up spin class again,  but I also did not sit on the saddle for the first week just to make sure.  

Urolift now available on the NHS in the UK; as is PAE and Rezum but only at certain hospitals. My preferred option for BPH symptoms was PAE however on investigation with Trans-rectal scan, my prostate was only 28g and hence did not qualify. As my flow was very poor, the Uro suggested HOLEP would be the normal course of action. However I held out for a Urolift as I didnt want retro and the small prostate size seemed ideally suited to Urolift. As many have mentioned the Uro' insisted that with retro everything would feel the same, just be dry but I didn't buy that nor want to lose that function. So we agreed on Urolift. He said it might not work and a bladder-neck incision might also be needed though we never really discussed that. I recalled after our meeting he said he'd get me to sign a form for a BNI as well in case that was needed; I was worried about that as the side-effects can be similar to Turp but thought oh well, if he's in there and thinks the bladder neck is more of a problem than the prostate then it makes sense to fix it while in there.

A cancellation came up last week (otherwise I was told I had a long wait) and I think I was selected out of three as my flow-rate was poor, 2.4 on Urodynamics compared to the Urologists own measurement on himself of 33. Thankfully when I got to the hospital there was no more muttering about BNI; only the urolift and that is all I was asked to consent to. I was the first one done. It was under general anaesthetic which I was thankful for.

When I came round I asked how many inserts and was told 5. Very uncomfortable for the first 8 hours. As I was a day patient, I had to leave around 6pm but didn't really feel like going anywhere. Problem was I had drunk a lot but wasn't peeing much though felt like I needed to very much! Anyway I was deemed good to go as I was at least peeing a little, no catheter. So we went somewhere nearby and then got home around 9pm. By this time flow was very good but only short bursts. Up about 6 or 7 times in the night, very urgent and painful.

Now on day 4 after the operation, flow still good but frequency and urgency an issue; I understand this takes time to settle down; possibly months. Pelvic floor painful and still some pain peeing but it is getting less. So far it is looking good due to the much better flow rate; like 10X improvement so it looks as though my small prostate was pressing in on the urethra and restricting it; I have a pre-op endoscope photo showing that.

I was fortunate that my Uro does both PAE and Urolift as otherwise if he had been PAE or HOLEP only, I might have had trouble and a long wait swapping horses on the NHS. I've heard Urolift is around £6,000 in the UK though I am not sure if that includes all the pre-op checks like cystoscopy, urodynamics, ultrasound. Somewhat unfortunately and maybe connected to being NHS, my Uro performed none fo the pre-op checks himself. Had he done the cystoscopy himself I think he would have been better placed to recommend a treatment. As it was the cystoscopy was done elsewhere with no video or photographic record and a report that said urethra and bladder neck normal which left us both confused. Anyway I think I ended up with the best solution.

Hope this helps anyone else in the UK.

HI CHARLES ,

I HAVE been off the site for a good while. i had the UL done 2.5 yrs ago, and after a few weeks i did have much improvement in urine flow & reduced bathroom trips at night to 1 or 2.

i took a med caused VESICARE after a few months which helped my bladder to relax and

improved my flow.About 6 months ago, symptoms returned and gradually I was back to

square one. just had the UL redone.. just local and some nitrous oxide. (helped a little).

He placed 6 clips this time as opposed to 4 the first time. I am 5 days post op, and so

far not much improvement, but I know I HAVE TO BE PATIENT! STILL taking VESICARE.

NO SEXUAL issues with VESICARE. MD said I WOULD haveto have LASER TMT NEXT TIME.

we have to give it more time. i am expecting a big improvement after a few more weeks.

I WILL CHECK BACK IN After a couple more weeks.

REGARDS,

HAL

I am now 7 days post op and still in pain and frequency is worse than before the op though some is attributable to drinking more. I am getting up typically 10 times now at night whereas pre-op it was 2 to 4 times. Is this normal for 7 days? The hype surrounding Urolift makes recovery sound like a walk in the park and that you can return to work in a few days. Flow is still good which is something I suppose but so far not worth the discomfort.

I am 61 and had 5 implants.

Charles Give yourself some time. I had a catheter for 3 days when I had mine. I think it is a good thing for any man with any procedure to have a catheter.....Because the prostate need time to relax and being that it is going to be swallow it will help you through the first 3 days of the spasms and bleeding. I went through some of what you are going through. I only had the catheter 3 days. ( It is up to the doctor if he put one in ) Each man heal in a different way and some take longer. After they took the catheter out. I did have to go to the bathroom All ways had the feeling. After 10 days it calmed down. If you have no more bleeding. You can stop drinking the extra water. Do not stop all together you have to drink water or juice. Stay away from any citrus juice because it will bother your bladder. You should be seeing more improvement No sex or any rough stuff until after 4 weeks. They want the clips to a hear to the prostate. It has been 3 1/2 year for me Prostate is still wide open. Just relax It will get better Ken

Day 8: Now I have an infection on top of everything else. Was up every hour last night; no sleep. Rang doctor who without seeing me or testing urine prescribed 2 weeks anti-biotic. When I collected them found out it was Cipro 2 X 500mg per day! Told my wife I was not taking that; too many horror stories out there. So took myself to a walk-in centre; UTI confirmed and some other anti-biotics given which I am just starting.

Absolutely no-way I can go to work yet but the Urolift hype suggests you can be back within a few days or even the next day. Can't even think about sex; everything to painful to contemplate. Seems like some have a much easier recovery.

Hey, thanks for the words of encouragement. This forum has certainly been more useful than any info I've got from the health service.

A shame I now have an infection but I may be prone to them as I had one a similar amount of time after the cystoscopy. I'm on MacroBid for the infection; preferable to 14 days of Cipro I think.

We'll see how it goes.

Two weeks

Still some pain in pelvic floor region. Just finishing anti-biotics which have solved infection for now. Urgency much less than last week but this and frequency not much different to pre-op; up 4 times in the night. Improvement in flow and feeling that my bladder is emptying better than pre-op. Jury still out on whether it was worth-it for me.