NICE medical technologies guidance addresses specific technologies notified to NICE by companies. The 'case for adoption' is based on the claimed advantages of introducing the specific technology compared with current management of the condition. This case is reviewed against the evidence submitted and expert advice. If the case for adopting the technology is supported, then the technology has been found to offer advantages to patients and the NHS. The specific recommendations on individual technologies are not intended to limit use of other relevant technologies which may offer similar advantages.
1.1 The clinical case for adopting the UroLift system for treating lower urinary tract symptoms of benign prostatic hyperplasia is supported by the evidence. The UroLift system relieves lower urinary tract symptoms while avoiding the risk to sexual function associated with transurethral resection of the prostate (TURP) and holmium laser enucleation of the prostate (HoLEP). Using the system reduces the length of a person's stay in hospital. It can also be used in a day‑surgery unit.
1.2 The UroLift system should be considered as an alternative to current surgical procedures for use in a day‑case setting in men with lower urinary tract symptoms of benign prostatic hyperplasia who are aged 50 years and older and who have a prostate of less than 100 ml without an obstructing middle lobe.
1.3 The primary cost drivers in the model were the cost of each implant and the number of implants used per treatment (the modelling assumed 4). Compared with monopolar and bipolar transurethral resection of the prostate (done as an inpatient procedure, which is most common), using the UroLift system in a day‑surgery unit results in cost savings of around £286 and £159 per patient. There was uncertainty over the procedure duration in the model, but this made little difference to the cost case.