The National Institute for Health and Care Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on insertion of prostatic urethral lift implants to treat lower urinary tract symptoms secondary to benign prostatic hyperplasia, in January 2014.
Benign prostatic hyperplasia (BPH) is a common condition that affects older men. It is characterised by an increase in the size of the prostate, which is caused by an increased number of stromal and epithelial cells. BPH can cause lower urinary tract symptoms including hesitancy during micturition, interrupted or decreased urine stream (volume and flow rate), nocturia, incomplete voiding and urinary retention.
Mild symptoms are usually managed conservatively. Drugs such as alpha blockers can be used to relax the smooth muscle of the urethra. Androgen blockers such as 5-alpha-reductase can also be used. If symptoms are more severe, then surgical treatments may be used including transurethral resection of the prostate (TURP) or transurethral vaporisation of the prostate, or holmium laser enucleation of the prostate (see NICE guideline CG97).
The OPCS-4 codes for Insertion of prostatic urethral lift implants to treat lower urinary tract symptoms are:
M67.8 Other specified other therapeutic endoscopic operations on prostate
Y02.2 Implantation of prosthesis into organ NOC
Y40.8 Other specified dilation of organ NOC
Z42.5 Urethra NEC
NHS England and Monitor have published information on payments for the insertion of prostatic urethral lift implants in England. This can be found in the 2016/17 national prices and national tariff enquiry log, on the NHS National Tariff Payment System 2016/17 government webpages.