Is UroLift better than PAE? (+3 differences)

In this brief article, we will discuss the comparison between UroLift and PAE. Furthermore, we will look at the common similarities and differences between the two procedures for benign prostate patients. 

Is UroLift better than PAE?

UroLift may be better for some BPH patients while PAE might be better for some other patients depending upon their characteristics. UroLift and PAE are both procedures to treat an enlarged prostate or benign prostate hyperplasia (BPH). 

UroLift is a minimally invasive procedure to treat BPH. This procedure is performed by uplifting and holding the enlarged prostate lobes by placing implants. This procedure is performed in the outpatient setup possessing minimum side effects (1). 

PAE (prostate artery embolization) is yet another minimally invasive procedure for BPH patients. During this procedure, a catheter is placed through the blood vessels into the arteries that supply blood to the prostate. The catheter slowly releases small particles to block or embolise the blood supply to the prostate to reduce its size (2). 

Whereas, BPH or benign prostate hyperplasia is a condition in elderly men in which their prostate gland grows abnormally leading to an obstruction in the urethra causing frequent urination, urinary incontinence, nocturia, and incomplete emptying of the bladder (3). 

However, BPH patients must always go with the procedure that their surgeon or urologist has recommended based on their health condition. Both PAE and UroLift procedures are less invasive and have reduced side effects.   

What does research suggest?

Based on research studies, it can be stated that not all BPH patients require emergency surgery or removal of the enlarged prostate tissue. Some patients may require pharmacological intervention while some may require minimally invasive procedures such as UroLift or PAE (4). 

PAE and UroLift, both procedures aim to improve the symptoms of BPH through different approaches. A wise choice should be made by your surgeon to choose the appropriate procedure for your health condition. 

What is the comparison between UroLift and PAE?

Following are some points to compare between UroLift and PAE procedures (1,2):

UroLift Prostate artery embolization (PAE)
Implants are placed to uplift the enlarged prostate tissue.  Small particles or embolic agents are injected into arteries to block blood flow to the enlarged prostate. 
Suitable for small to medium-sized prostates.  Suitable for large-sized prostates.
Outpatient procedure. Outpatient procedure.
Less invasive. Minimally invasive.
Performed under local anaesthesia. Performed under local anaesthesia. 
Preserve sexual activity.  Preserve sexual activity. 
Quick recovery.  Recovery may take some time. 

However, above are some comparison points mentioned between UroLift and PAE. The comparison indicates different methods for both procedures. However, both procedures are minimally invasive with few side effects. 

How to choose between UroLift and PAE?

The selection between UroLift and PAE depends upon your surgeon or urologist. Your surgeon may examine you, your symptoms, and your anatomy and then suggest the most appropriate procedure for your condition. 

There is a different patient selection criteria for both these procedures. BPH patients with small to medium-sized prostate must undergo the UroLift procedure (1). Whereas, BPH patients with a large prostate must be recommended to undergo PAE. 

Both procedures are equally invasive and safe in terms of side effects. Therefore, this might not be considered before choosing the appropriate procedure for you (1,2). 

However, the patient’s anatomy plays a major role in selecting the appropriate procedure for them. PAE is suitable for a broader category of patients while for UroLift, a specific shape and size of prostate is the basic requirement. 

However, you must always discuss the appropriate medical approach for yourself with your doctor. They must outweigh the pros and cons of UroLift with PAE to suggest the right procedure for you. 

In my opinion

In my opinion as a pharmacist, you must consider any procedure of the above two, as both are less invasive procedures with minimum side effects and preservation of sexual activities. 

Your urologist may assess you completely before suggesting either UroLift or PAE depending upon different factors. However, some Urolift patients have shared positive and satisfied testimonials regarding the procedure. 

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References

1.-

Jones, Patrick, Bhavan P. Rai, Omar Aboumarzouk, and Bhaskar K. Somani. “UroLift: A New Minimally-invasive Treatment for Benign Prostatic Hyperplasia.” Therapeutic Advances in Urology 8, no. 6 (2016): 372-376. Accessed January 23, 2024. https://doi.org/10.1177/1756287216671497.

2.-

Maclean, Drew, Ben Maher, Sachin Modi, Mark Harris, Jonathan Dyer, Bhaskar Somani, Nigel Hacking, and Timothy Bryant. “Prostate Artery Embolization: A New, Minimally Invasive Treatment for Lower Urinary Tract Symptoms Secondary to Prostate Enlargement.” Therapeutic Advances in Urology 9, no. 8 (2017): 209-216. Accessed January 23, 2024. https://doi.org/10.1177/1756287217717889.

3.-

Ng M, Leslie SW, Baradhi KM. Benign Prostatic Hyperplasia. [Updated 2024 Jan 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558920/

4.-

InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Benign enlarged prostate: What are the pros and cons of surgery? 2008 Oct 13 [Updated 2018 Jan 25]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK481492/