Prostatic urethral lift (UroLift), one of the treatment methods for benign prostatic hyperplasia (BPH), is a procedure that secures the urethra by tying the left and right sides of the enlarged prostatic tissue with implants. Unlike methods that involve resecting the prostate or burning it with a laser, it is a relatively simple surgery performed under local anesthesia, offering the advantage of a low risk of side effects and complications. It is particularly known as an effective treatment option for chronic disease patients for whom general anesthesia is difficult, or for patients with a small prostate size and no median lobe.
However, as with all surgeries, prostatic urethral lift does not offer 100% permanent effectiveness. In some patients, reoperation may be necessary over time, with representative cases including perineal pain, persistent hematuria, and the recurrence of voiding dysfunction.
Firstly, perineal pain between the testicles and the anus can be cited. The prostatic urethral lift procedure involves pushing and fixing the hypertrophied prostatic tissue to the side using prostatic urethral implants. Therefore, if the prostatic urethral implant is deeply fixed, pain may be induced in the perineal area. In most cases, this perineal pain generally improves after about 3 months post-surgery, but occasionally, pain persists even 1-2 years after surgery. In such instances, it is necessary to consider reoperation to remove the prostatic urethral implant.
Secondly, if hematuria persists, it is necessary to conduct a careful examination. Occasionally, the prostatic urethral implant may protrude outside the prostate or towards the bladder. In such cases, stones may form at the site of the protruding implant, and this can lead to persistent hematuria. If such stones form inside the bladder, irritative symptoms such as frequent urges to urinate or difficulty holding urine may appear. When these voiding symptoms are present, the problem at the procedure site should be reconfirmed through ultrasound or cystoscopy.
Lastly, it is the case where benign prostatic hyperplasia fundamentally recurs, such as the reappearance of voiding symptoms. As aging continues and the prostate continues to enlarge, the fixation effect of the implant may weaken. Therefore, if voiding symptoms become as uncomfortable as they were before the surgery, reoperation should be considered.
If the three symptoms mentioned above occur, reoperation for benign prostatic hyperplasia may be necessary. Reoperation is typically performed in the form of resecting the prostate while removing the prostatic urethral implant. Amidst the emergence of various surgical methods for benign prostatic hyperplasia, recently, HoLEP (Holmium Laser Enucleation of the Prostate) surgery using a holmium laser is widely performed.
Director Choi Ho-cheol of Goldman Urology Dongtan Branch stated, "It is true that many surgical methods have been introduced in Korea as the number of benign prostatic hyperplasia patients continuously increases, and UroLift is one of them. However, since no surgery can be 100% perfect, it is necessary to consider that reoperation may be required. If the three symptoms mentioned earlier appear, I would strongly recommend consulting with a urology specialist."