I had a urolift performed approx 6 weeks ago which I thought was for an enlarged prostate. However having now received a copy of the letter from my urologist to my GP it seems that the problem was not prostate but a 'raised bladder neck'. I am not sure if this condition is linked to a median lobe on the prostate. The letter refers to 5 urolift implants to pull the bladder neck in various directions. My flow has improved and frequency decreased. I still have some pain around the prostate/behind the right testicle which I am not sure of whether it is operation trauma of an insert pulling. I must say it was rather a shock to find that my prostate was OK (I had been considering PAE but my prostate was too small) and that the bladder neck had been treated instead using Urolift which I thought was only designed to treat prostate enlargement. Has anyone else had Urolift for this condition or can comment on its use around the bladder neck or to move a median lobe?
I was told the same thing after a cystoscopy several months ago. I’m very curious to hear about your recovery. My Uro said I need a TURP as well. I said no thanks and have done nothing. I haven’t slept longer then 2 hrs in 7 years. I’m 62. I would love to get a good night’s sleep again!
Best wishes,
Kenny in MN
Andrew.
Where are you at.
When they told you they were doing the Urolift did they tell you anything about doing anything to your bladder neck. There are doctors in the UK that are adding a bladder neck procedure to the Urolift. Most of the men after a year still have pain and are leaking from holding the bladder neck open and will cause retro. There were never any trails on it per the company .
Good luck…Ken
Hi , according to my knowledge and experience , the best method for median lobe obstruction is ** REZUM and FLA . I underwent FLA in April 2018 in Houston** .
PAE for this diagnosis has poor results.
Difficult is for Urolift, although there is new modification MEDLIFT of Urolift .
The middle lobe is part of the prostate that grows up beneath the bladder neck and either elevates the bladder neck or actually protrudes into the bladder. “All of the treatments for middle lobe are made more difficult because of this protruding tissue into the bladder,” Dr Rukstalis told Renal & Urology News. “Certainly standard transurethral resection tools can resect a middle lobe, but there is real risk of bladder neck perforation and undermining the bladder neck.”
The original LIFT trial focused on the treatment of the lateral lobes. “It was decided at that time that men with middle lobe enlargement were a different group of men and would not be examined in that trial,” Dr Rukstalis related. “So ultimately after that trial was successfully completed, middle lobe became a contraindication for the use of the UroLift. The MedLift trial was then designed as an extension of the original LIFT trial to address the treatment of the middle lobe.”For the MedLift trial, surgeons treated the lateral lobe in the standard manner and then treated the middle lobe with a new modification of the UroLift procedure that involved manipulating the middle lobe, displacing it to one side or the other of the prostate, and then implanting one of the lift devices to hold it displaced, further opening the bladder neck, he explained.
As with the established UroLift procedure, adverse events associated with middle lobe treatment were mild to moderate and resolved quickly. The improvements in LUTS mirrored, or even exceeded, those observed in the original LIFT trial.
In December of last year, the FDA approved extending the indications for UroLift to include treatment of the middle lobe. In addition, since the original approval of Urolift, FDA approved it for use in men aged 45 and older rather than 50 and older.
Reference
Rukstalis D, Grier D, Stroup S, et al. Multi-center prospective study of the prostatic urethral lift for obstructive median lobe: The MedLift study, an extension of the LIFT randomized study. Oral presentation at the American Urological Association 2018 annual meeting in San Francisco, May 18–21. LBA15.
Important note :
Large Median Lobe protruding to bladder and causing obstruction are acting as Ball-Valve . This is the Reason Why Pills for Enlarged Prostate Such as Flomax and Finasteride (Proscar), Tamsulosin, Silodosin (Rapaflo) and Uroxatral (Alfuzosin) Do Not Work Well.
see enclosed my ball valve .
Good morning
Yes I still think as of May they are still in trail of working with men that have a larger prostate of over 100. They feel that the Urolgist can just pull the median lobe to one side and it will stay out of the way of the bladder neck.
There were no trail on the Urolift using it on the bladder neck. Doctor are just doing this. Andrew should have been told about it.
There are a few guys in the UK that they are having a problem. One man after a year is still have a problem. Still some pain and leaking. He has to ware a pad. Not a happy man
Man have to remember that if they do this it is 2 procedure and each has it own healing time. Urolift has about 4 to 6 weeks to heal and the bladder neck can take 12 weeks or more
Also Urolift has no side effects at all. Doing anything with the bladder neck you may end up with side effect. Being the bladder neck will not close right you can end up with leaking and retro ejaculation.
Research anything you are having don and make you you know what your going to have. Surprises are not good…Ken
Do you mean two hours a night or several two hour naps. If only two hours how do you manage to function during the day ? Probably in my case it is due one of the many effects of Cipro/Flouroquinolones. I waken after two hours and have difficulty getting back to sleep and if then for no more than an hour.
Ken,
I don’t know why you are saying: "Most of the men after a year still have pain and are leaking from holding the bladder neck open and will cause retro. There were never any trails on it per the company
There was a one year clinical trial on the Medlift procedure, that Stan mentioned. It was presented at the American Urological Association 2018 annual meeting in San Francisco, May 18–21, 2018. LBA15. Look it up on Google and read it. The results looked good. The clinical trial was funded by NeoTract, the company that invented Urolift.
As I understand, by a phone conversation with a NeoTract representative, The company is in the process of training doctors how to do the new procedure. NeoTract sends a team to each doctors location that assists the doctor in performing his first Medlift procedures.
Thomas
Sleeping in 2 hour segments was my life because of BPH. I then had a Greenlight procedure that had a bad outcome (permanent incontinence caused by strictures at the external sphincter as a result of the GL mishap). Finally, I had an AUS implant, so now I do manage to have a 4 or 5 hour segment of sleep.
2 hour naps would be a better description. I start work at 4 am, so I sleep in shifts. Afternoon naps rarely last more then an hour. Heaven forbid if I should have some beers in the evening!
Thomas
I have read the trails and it has nothing to do with a bladder neck procedure. It has to do with taking the median lobe out of the bladder to open it up. They do not touch the bladder neck There have been no trail on putting clips on the bladder neck at all.
The men I’m taking about are the men that the doctors are using in the uk. One man in particular in the UK was going for just a Urolift that is all he needed Small Prostate Just before he was taking in the the surgery room he saw his doctor.
The doctor said i just saw a new way of doing the Urolift it’s going to make it better. Well when he woke up he was in so much pain the doctor did not know what to say
It has been over a year he is still in pain and has to ware diapers because he leaks. This should have not happen.There was no trail on this what so every. That means no data.The Urolift stand by itself and if another procedure is added it changes the procedure and it side effect.
I also have been on the phone and e-mail with the company, the management and a guy name of Ted who was one of the inventors of the Urolift. They need to start to stand up to the doctor for there procedure.
The Urolift has worked for many men. And with them working on the median lobe it will save a lot of men from having a surgery they do not need.
Have a great day…Ken
Hello Glenn
I’m sorry I forgot that you had that done.
How is it working out. Has it been about 6 month’s. I hope it is doing well for you. It may be a little different be it give you somewhat a normal outcome.
Take careKen
I do have pain but it is not too bad; just annoying; like I have a permanently bruised testicle or something pinching inside. Thankfully no leakage and symptoms have improved vs. pre-op. I am more comfortable and able to drink more without endless trips to the toilet.
I was not told work might be done on the bladder neck. The problem was, in my case, that the flexible cystoscopy was performed by someone else who just said prostate slightly enlarged and bladder neck normal. It is unfortunate that my urologist did not do the cystoscopy himself as then I would have had better information.
I guess when the uro was in there he saw that the prostate was not a problem but the raised bladder neck was and used the urolift to sort it out. He did say he had performed on median lobes before with urolift even though it is only a recent extension to the use of urolift.
Some better information pre-op would have been useful; for years I thought I had an enlarged prostate and was being treated as such by my GP. No wonder Tamsulosin wasn’t doing much for me.
In summary, I think I was fortunate to have a urologist that knew how to use Urolift to sort out a median lobe causing the bladder neck to be raised. Shame I have some pain still; will have to see how that goes.
Andrew
Yes I’m glad your doing ok. But you also can say you were fortunate but he had no permission to touch your bladder neck. That is a whole different procedure with a whole different healing time and side effects. If you had a median lobe problem all he had to do is clip the lobe to the one side. That would get it out of the way.
It can something take 12 weeks our longer to heal and of course it can cause retro. This should have been disgust before surgery.
How would you like to go into a surgery for one thing and then come out with something else. Another thing why 2 different doctors. If you had the other doctor he would have done the wrong thing. It is 2 different doctor
I for one have learn the hard way. I do not give total control to the doctor. After reading what he is going to do and we have talk that is it nothing else. No thinking this would be better this way or maybe I will add this.
Not going to talk amount it anymore. It just makes me upset
Have a good day.What done is done .Ken
Hi Kenny,
If your raised bladder neck is caused by a median lobe then the latest urolift techniques can help with median lobes but you need a urologist who knows what to do; I would imagine an inexperienced one could cause problems.
See elsewhere in this thread for how I’m doing. Now its settling a bit I’m back down to getting up twice a night on average from 2 to 6 times pre-op and similar just after op. Last night was only once!
Hi Kenneth,
He was in there with permission to do a urolift. There was no bladder neck incision; only the urolift. I guess he saw the most likely problem and thought urolift could fix it and fixed it; why not as I was already under a general. I agree its different to what I had expected but he didn’t know himself either until he took a look.
The reason someone else did the initial cystoscopy is that it was a lower-skilled person and in the UK, on the free NHS it is difficult to get to see the main consultant for routine stuff and waiting times are huge. They should have recorded the cystoscopy for the consultant to review but didn’t; just wrote a report that everything looked normal.
Andrew
I know what you are saying but they should not put any clips on the bladder neck. It should have not even been touch
The doctor takes the median lobe and bring it to one side and it clip there on the prostate or by the prostate. That will open up the bladder neck.
What it came down to is that he did something that you did not give him permission to do. Which was not right. It should have been your choice not his. If I read your first post right you have no clips on the prostate but 5 on the bladder neck.
But what done is done. It’s your body you have to live with the outcome not the doctor
Ken
Andrew
Yes you gave him permission to do a Urolift on your prostate. That you agreed to But that was not done. He did a whole new procedure on your bladder neck.
There are no trails or data on that procedure so we do not know if it will work how long the heal time is and the side effects.
I wrote the company again this morning after I read you post. This has to stop. It is one thing to add something to the procedure but to do a whole new one when it has not been tested. Is very wrong on the doctors part.
You should have been told first not after the fact. I do hope all goes well for you because the anchors can not be taking out. Unless they cut out…Ken
There is/was the ‘MedLift’ trial in Feb 2018 to treat median lobe.
Now I am not 100% sure but think a raised bladder neck is caused by the median lobe. Therefore as the Urolift has now been approved for treatment of median lobes and my Uro said he had done some already, then I think what he describes doing is to move the median lobe off the bladder neck.
Here is a quote from the letter the Uro wrote to my GP; see what you think “Five devices were deployed, two near the bladder neck at 10 and 2 o clock, two more laterally, and then one more at around 5 o clock to pull the bladder neck down”
Actually looking at the MedLift trial, it seems you are right, just one device to hold the median lobe off.
Well I’ll see what I can find out in January though the follow-up appointment is not with the urologist just a specialist nurse.