Are you put to sleep for UroLift procedure?

After the surgery, most men are able to pass urine without the need for a catheter in situ post-operatively. The surgery can be carried out either under sedation, or under a general anaesthetic, so that the patient is asleep throughout the procedure.

bladderandbowel.org - Prostatic Urethral Lift Procedure (Urolift® System)

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The Urolift is a relatively new surgical procedure designed to treat men who have benign prostatic enlargement (BPE). It is suitable for those patients where medication has been tried but has not been tolerated, or where it has not been effective. Typically those patients who respond well to this surgery are those whose prostate is not very enlarged. It may well suit the younger man who wishes to minimise the sexual side effects experienced from taking medication, and those men who find the side effects of conventional surgery unacceptable.

The Procedure

A small telescope-like instrument is passed along the waterpipe (urethra). This instrument allows a small band, similar in design to a treasury tag, to be passed between the inner and outer surface of the lobe of the prostate gland. This small implant retracts part of the lobe of the prostate, relieving the pressure/obstruction on the urethra, and obviating the need for any cutting or burning of tissue. The number of bands put in place depends on the size and shape of the prostate. After the surgery, most men are able to pass urine without the need for a catheter in situ post-operatively. The surgery can be carried out either under sedation, or under a general anaesthetic, so that the patient is asleep throughout the procedure. The choice of sedation or general anaesthetic will be determined following discussion with the surgeon and anaesthetist. In general, patients will go home the same day the surgery is performed.

Benefits of Urolift

In most cases there is immediate improvement in the ability to pass urine, with the risks of sexual dysfunction being extremely small.

Suitability of Urolift

It is vitally important that the consultant carries out a full individual examination to assess current voiding function, shape and size of the prostate, sexual function, and the necessary evaluation for prostate cancer. Patient expectations following surgery must be considered, as should other types of treatment available for BPE.

Side Effects of the Urolift

These are some of the more common side effects that may occur following the procedure:

Sensitivity when passing urine

Urinary frequency

Strong urge to pass urine at times

Minimal bleeding

General pelvic discomfort/pain

Urinary leakage (relatively uncommon) but linked to urge

Urinary tract infection (occurs in approximately 5% patients)

Side effects from the anaesthetic

Avoid heavy lifting and straining

Light exercise is okay

Avoid getting constipated

Try not to go to the toilet ‘just in case’ so that the bladder learns to behave more ‘normally’

Avoid long journeys or prolonged periods of sitting

Avoid sexual activities

Maintain a good fluid input of between 1.5-2 litres per day

Drink steadily throughout the day

Don’t drink too much tea or coffee (caffeinated drinks), fizzy drinks, or alcohol, as these may irritate the bladder

Have a couple of weeks off work

Avoid driving unless absolutely necessary, and definitely no driving in the first 24 hours following the surgery

Available Evidence

Approval by NICE, January 2014

In men treated with Urolift, 50% showed improvement in flow rate (twice that of drugs but less than after TURP or HoLEP) 50% improvement of reported symptoms (up to 2-3 times better than drugs, but less than TURP or HoLEP)

No sexual dysfunction (always some degree of dysfunction following other surgeries)

As with any surgery, it is vitally important to discuss the operation, benefits, pitfalls, side effects, long-term effects, and personal expectations in full with the consultant. This surgery is not suitable for every man with BPE. More information can be found at https://uk.urolift.com/

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Do you have to wear a bag with a suprapubic catheter?

Other supplies you will need are sterile gloves, a catheter pack, syringes, sterile solution to clean with, gel such as K-Y Jelly or Surgilube (do not use Vaseline), and a drainage bag. You may also get medicine for your bladder. Drink 8 to 12 glasses of water every day for a few days after you change your catheter.

mountsinai.org - Suprapubic catheter care Information | Mount Sinai - New York

Your catheter will make it easier for you to drain your bladder and avoid infections. You will need to make sure it is working properly. You may need to know how to change it. The catheter will need to be changed every 4 to 6 weeks. You can learn how to change your catheter in a sterile (very clean) way. After some practice, it will get easier. Your health care provider will change it for you the first time. Sometimes family members, a nurse, or others may be able to help you change your catheter. You will get a prescription to buy special catheters at a medical supply store. Other supplies you will need are sterile gloves, a catheter pack, syringes, sterile solution to clean with, gel such as K-Y Jelly or Surgilube (do not use Vaseline), and a drainage bag. You may also get medicine for your bladder. Drink 8 to 12 glasses of water every day for a few days after you change your catheter. Avoid physical activity for a week or two. It is best to keep the catheter taped to your belly. Once your catheter is in place, you will need to empty your urine bag only a few times a day.

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