6 Conclusions

6 Conclusions

6.1 The Committee concluded that the UroLift system is effective in relieving symptoms of benign prostatic hyperplasia. It noted that the degree of symptom relief outcomes is slightly less than that after transurethral resection of the prostate (TURP) or holmium laser enucleation (HoLEP), but it is sufficient and clinically important. The Committee recognised that the duration of symptom relief after using the UroLift system is uncertain. It concluded that it is similar in the medium term (up to 3 years) to the comparators but that further evidence on durability and the need for subsequent procedures would be useful.

6.2 The Committee considered the evidence that the UroLift system does not damage sexual function to be convincing. This contrasts with a substantial risk to erectile and ejaculatory function after TURP or HoLEP and represents a significant advantage for men who wish to preserve their sexual function.

6.3 The Committee noted that evidence for avoiding catheterisation after the UroLift system was sparse, but accepted expert advice that catheterisation time would be reduced and in many cases catheterisation would be avoided, especially as surgeons gain experience with the procedure. It also concluded that it was reasonable and likely that the UroLift system would be used as a day‑surgery procedure, often under local anaesthetic.

6.4 Based on the day‑surgery scenario in the cost model, and assuming a maximum of 4 implants are used, the Committee concluded that using the UroLift system is likely to be cost saving compared with TURP. However, the Committee also concluded that at the current costs of implants, using the system in an inpatient setting was likely to be more costly than either TURP or HoLEP.

Andrew Dillon
Chief Executive
September 2015

  • National Institute for Health and Care Excellence (NICE)