1 Recommendations

1.1 Evidence supports the case for adopting the UroLift System for treating lower urinary tract symptoms of benign prostatic hyperplasia. The UroLift System relieves lower urinary tract symptoms, avoids risk to sexual function, and improves quality of life.

1.2 The UroLift System is a minimally invasive procedure, which should be considered as an alternative to transurethral resection of the prostate (TURP) and holmium laser enucleation of the prostate (HoLEP). It can be done as a day-case or outpatient procedure for people aged 50 and older with a prostate volume between 30 and 80 ml.

1.3 Cost modelling shows that the UroLift System is likely to be cost saving compared with standard treatments, because of reduced length of stay and procedure time. Over 5 years, if done as a day‑case procedure, UroLift is estimated to save, per person:

  • £981 compared with bipolar TURP

  • £1,242 compared with monopolar TURP

  • £1,230 compared with HoLEP.

    Cost savings are uncertain compared with transurethral water vapour therapy using Rezum and when UroLift is used for treating an obstructive median lobe.

Why the committee made these recommendations

The UroLift System inserts implants using a minimally invasive procedure. The implants hold obstructing prostate tissue away from the urethra so that it is not blocked. The aim is to relieve lower urinary tract symptoms such as difficulty urinating.

New clinical evidence available since the original guidance was published in 2015 shows that UroLift relieves lower urinary tract symptoms for up to 5 years. It also shows that UroLift improves quality of life and avoids risk to sexual function.

Cost analyses suggest that using UroLift instead of TURP or HoLEP is likely to be cost saving. This is because UroLift is done as day surgery with reduced operating and recovery costs. Compared with Rezum, cost savings for UroLift are uncertain and depend on whether flexible cystoscopy is used before the procedure and the number of implants needed for UroLift. The additional implants needed when UroLift is used for obstructive median lobe treatment mean that there may be additional costs when compared with Rezum.

  • National Institute for Health and Care Excellence (NICE)