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 prostate tissue with implants. Unlike methods that involve excising 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 for patients with chronic diseases who have difficulty undergoing general anesthesia, or for those with a small prostate size and no median lobe.
However, like all surgeries, prostatic urethral lift does not guarantee 100% permanent effectiveness. Some patients may require reoperation over time, with typical cases including perineal pain, persistent hematuria, and the recurrence of voiding dysfunction.
The first factor is perineal pain, which occurs between the testicles and the anus. Prostatic urethral lift involves pushing the enlarged prostate tissue aside and securing it with prostatic implants. Therefore, if the prostatic implants are deeply fixed, pain may be induced in the perineal area. While it is common for such perineal pain to improve approximately three months after surgery, there are occasional cases where the pain persists even one to two years post-surgery. In such instances, considering a reoperation to remove the prostatic implants may be necessary.
Secondly, if hematuria persists, a careful examination is warranted. Occasionally, prostatic implants may protrude outside the prostate or towards the bladder. In such cases, stones can form on the protruding implant site, leading to persistent hematuria. If these stones develop inside the bladder, irritative symptoms such as frequent urges to urinate or difficulty holding urine may occur. When these voiding symptoms are present, the problem at the procedure site should be re-evaluated through ultrasound or cystoscopy.
Lastly, there is the case where benign prostatic hyperplasia fundamentally recurs, with voiding symptoms reappearing. As aging progresses, the prostate continues to enlarge, which can weaken the fixation effect of the implants. Therefore, if voiding symptoms become as uncomfortable as they were before the surgery, reoperation should be considered.
If the three aforementioned symptoms occur, reoperation for benign prostatic hyperplasia may be necessary. Reoperation typically involves removing the prostatic implants while simultaneously excising the prostate. Among the various surgical methods for BPH that have emerged, HoLEP (Holmium Laser Enucleation of the Prostate) surgery, utilizing a holmium laser, is widely performed recently.
Director Choi Ho-cheol of Goldman Urology Clinic Dongtan Branch stated, "It is true that many surgical methods have been introduced in Korea, including UroLift, as the number of BPH patients continues to increase. However, since no surgery can be 100% perfect, it is important to consider that reoperation may be necessary. If the three symptoms mentioned earlier appear, I strongly recommend consulting with a urology specialist."