Does the UroLift procedure fail? (+5 complications)

In this article, we will discuss whether the UroLift procedure normally fails or not. We will look at the ratio between UroLift’s failure and success. Furthermore, we will look at the complications associated with UroLift failure. Along with that, we will undergo some ways to avoid long-term UroLift complications. 

Does the UroLift procedure fail?

Yes, the UroLift procedure may fail sometimes. Generally, the UroLift procedure is considered safe and effective for many patients of benign prostate hyperplasia (BPH). However, the rate of UroLift failure or success verily depends upon various factors.  

UroLift is a non-invasive method of treatment for BPH patients. It is a recently introduced method in which small implants are placed into the prostate to lift and hold the enlarged prostate away from the urethra to ease the flow of urine in BPH patients (1).

The UroLift procedure does not allow the complete removal of the enlarged prostate tissue. Rather it aims to provide symptom relief while minimally affecting the sexual function of the patients (1).  

Generally, the UroLift procedure is safe and successful. However, some patients may face UroLift failure due to the procedure technique or the individual patient’s anatomy. 

What does research suggest?

Based on research studies regarding the failure rate of the UroLift procedure, it is stated that in 2 years, the UroLift has been associated with a failure rate of 7% while in 4 years, the failure rate of UroLift spiked up to 14% (2). 

A UroLift failure case was reported of a 72-year-old patient who was fit and ready to undergo a UroLift procedure. He presented with recurrent urinary tract infections and lower urinary tract symptoms (2).

During the UroLift procedure on this patient, 4 implants were placed which established a wide open channel. However, after the procedure, the patient developed acute urinary retention, and after a week of the UroLift procedure, he confirmed a complete urinary flow obstruction (2). 

However, after the failure of the UroLift procedure, this patient was offered another procedure to completely remove the enlarged prostate tissue which was successful (2).

With the increasing popularity and use of the UroLift procedure for BPH patients, surgeons and urologists must be careful about the 14% treatment failure and must always be prepared to perform secondary procedures in case of UroLift failures (2). 

What are the complications of the UroLift failure?

The following are some common complications of the UroLift procedure failure (3):

• Implant issues- The most common problem has been related to the device implant. Displacement and migration of UroLift implants may also occur. Cases have been reported regarding the failure to properly deploy the implants. 

• Pain and discomfort- The failure of the UroLift is associated with pain and discomfort in the pelvic area of the patients. 

• Hematuria- The appearance of blood in the urine (hematuria) has also been observed in the patients who undergo the UroLift procedure. 

• Intensive therapy- After a UroLift procedure failure, some intensive therapy unit (ITU) admissions have also been seen. Some of which resulted in the deaths of patients. 

• Urosepsis- Patients who had a failed UroLift procedure have a higher chance of developing a urosepsis (sepsis due to urinary tract infections). 

However, the incidence of such complications with UroLift failure may occur. Patients must discuss the potential risks and complications with their urologists before undergoing the UroLift procedure. 

What are the ways to avoid UroLift failure?

The most important step to avoid a UroLift failure is to thoroughly assess and select the patients that can undergo the UroLift procedure. Careful patient selection is extremely crucial for a successful procedure (1).

The urologist must conduct a thorough examination and evaluation of the patient’s urinary symptoms and prostate anatomy before the procedure to avoid failure. 

The patients must always refer to specialised urologists or surgeons for undergoing UroLift procedures. Going to a skilled professional can reduce the chances of UroLift failure. 

The urologist or surgeon must always outweigh the pros and cons of the procedure. If the advantages outweigh the disadvantages, then they must allow the patient to undergo the procedure. 

Post-procedural care and follow-up appointments are extremely essential to ensure the proper success of the UroLift procedure. The patients must regularly examine themselves for any unusual symptoms and must regularly attend follow-up appointments. 

In my opinion

In my opinion as a pharmacist, it is commonly observed that the UroLift procedure is a safe and efficient treatment for BPH patients. Patients who have undergone UroLift’s successful procedure have given some positive reviews and improvements in their overall health and symptoms. 

However, due to many factors, a UroLift failure may also occur. You must openly discuss the potential risks and complications before undergoing the UroLift procedure to avoid its failure and further adversities. 

References