Urolift: a new chapter in benign prostate hyperplasia (BPH) therapy

For over 30 years transurethral resection of the prostate (TURP) has held onto its crown as the gold standard surgical intervention for benign prostate hyperplasia (BPH), a disease process, which affects nearly 30 million men in Europe (1). However, minimally invasive alternatives such as Holmium laser enucleation of the prostate (HoLEP), thulium laser vapo-enucleation of the prostate (ThuVEP) and prostate artery embolization (PAE) have challenged the current status of this cornerstone treatment and re-shaped the surgical landscape accordingly (2-4). The urolift device (NeoTract Inc., Pleasanton, CA, USA), formally referred to as prostatic urethral lift (PUL), has attracted increased attention among the urological community and is the latest endoscopic method for BPH treatment (5). This novel technology deploys adjustable implants to establish a clear channel in the prostatic fossa via mechanical retraction of the lateral lobes. Potential advantages include a short learning curve and its use in the office setting as a day case procedure under local anaesthetic (LA). It is therefore an option for patients with multiple co-morbidities and patients at a higher risk of general or regional anaesthesia. Importantly, multiple clinical studies have reported no adverse sequelae on sexual function, which has an additional appeal for younger men. Although the long term efficacy of TURP is well recognised, it is associated with retrograde ejaculation in up to 75% of cases (6).