Prostatic Urethral Lift

Before a prostatic urethral lift, you’ll meet with a healthcare provider. They’ll evaluate your general health and take vitals (temperature, pulse and blood pressure). They may also order tests or procedures to help determine the size of your prostate and the severity of your BPH, including:

• Urine flow test. This test measures the speed and strength of your pee stream. It also measures the amount of pee.
• Post-void residual volume test. This test measures how much pee is still in your urinary bladder after you pee.
• Transrectal ultrasound. A provider will insert a probe into your anus (butthole) to take images of your prostate. The probe uses high-energy sound waves, which travel through your rectum and bounce off organs and tissue in the area.
• Cystoscopy. During a cystoscopy, a provider will insert a small, flexible tool with a camera and a light at the end of it (cystoscope) to see inside your urethra and bladder.
• Urinalysis (urine test). A urine test evaluates how your pee looks, as well as any chemicals, bacteria or other microscopic components in your pee. If urinalysis shows bacteria in your pee (urinary tract infection or UTI), you may need to treat the infection before you can have a PUL.

Tell your provider if you’re taking any prescription or over-the-counter (OTC) medications, including herbal supplements. Aspirin, anti-inflammatory drugs and certain herbal supplements can increase your risk of bleeding.

Your provider will also give you specific directions on when to stop eating and drinking before the procedure. In preparing for a PUL, most people shouldn’t eat or drink anything at least six hours before the procedure. If you must take prescription medications by mouth, take them with a small sip of water.

A PUL may take place in an office or at an ambulatory surgery center. You’ll change into a hospital gown for the procedure, so it’s a good idea to wear clothes that are easy to take off.

Though a PUL is a minimally invasive procedure, it can be nerve-wracking whenever you go through a medical procedure. In most cases, a provider will give you a mild sedative to help you relax. It’s a good idea to have a friend or family member drive you home after the procedure.

A special team of healthcare providers will perform a prostatic urethral lift. The team typically includes a urologist (surgeon) and nurses.

A nurse will lead you to a surgical table and instruct you to lie on your back. You’ll lift your legs, spread them apart and bring them to rest in padded stirrups that keep your legs up and open (dorsal lithotomy position). This position allows your providers to see and access your urethra easily.

In most cases, a healthcare provider will give you local anesthesia. Local anesthesia numbs your urethra and the surrounding areas so you won’t feel pain during the procedure.

Once you’re numb, your surgical team will:

• Place a urinary catheter to drain pee from your bladder.
• Insert a cystoscope into your urethra and pass it through to your bladder to see inside your body as they perform the PUL.
• Insert a device (UroLift) into your urethra and move it forward to the side walls of your prostate. The UroLift then uses a small needle to eject small, thin, stainless-steel implants into both sides of your prostate. The implants pull prostate tissue away to open your urethra. Depending on your prostate’s size, your urologist may place two to six implants.