Prostatic urethral lift (UroLift) is a minimally invasive procedure used to treat benign prostatic hyperplasia (BPH). Instead of removing prostate tissue with surgery or laser, this technique uses small implants (prostatic urethral lift implants) to pull the enlarged prostate tissue to the sides, thereby widening the urethral passage and improving urine flow. The procedure is often performed under local anesthesia, making it a suitable option for patients who may have concerns about general anesthesia, particularly those with relatively small prostate size and no significant median lobe enlargement.
However, as with any medical procedure, the long-term effectiveness of UroLift is not identical for all patients. Over time, some individuals may experience changes in symptoms, and certain clinical signs may indicate the need for further evaluation or additional treatment.
The first potential issue is perineal pain, which occurs in the area between the scrotum and the anus. Because the procedure involves anchoring implants into the prostate tissue to hold it apart, deeper placement of these implants may lead to localized discomfort in the perineal region. In most cases, this pain improves within approximately three months after the procedure. However, in some patients, discomfort may persist for one to two years. In such cases, imaging or endoscopic evaluation may be required to assess implant positioning, and removal may be considered if necessary.
The second concern is persistent hematuria (blood in the urine). In certain cases, the implant may protrude toward the outer prostate capsule or into the bladder. When this occurs, stones can form around the exposed implant, leading to hematuria. If bladder stones develop, patients may also experience urinary urgency, frequency, or difficulty holding urine due to irritation of the bladder lining. When these symptoms are present, further evaluation using ultrasound or cystoscopy is recommended to assess the condition of the implant and surrounding structures.
The third scenario involves the recurrence of urinary symptoms, indicating progression or recurrence of BPH. Because prostate enlargement can continue as part of the natural aging process, the mechanical effect of the implants may weaken over time. If urinary symptoms return to a level similar to those experienced before the procedure, additional treatment options should be discussed with a urologist.
When these types of symptoms occur, further treatment may be necessary depending on the patient’s condition. In some cases, this may involve removal of the implants followed by definitive surgical treatment. One commonly used option is holmium laser enucleation of the prostate (HoLEP), which removes the enlarged prostate tissue more completely.
Although UroLift is considered a relatively simple and minimally invasive procedure, it is important to understand that its results may not be permanent for every patient. Persistent perineal pain or recurrent hematuria may indicate implant-related issues that require further evaluation. Careful follow-up and individualized treatment planning are essential to achieving optimal long-term outcomes.