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UroLift for Treating Lower Urinary Tract Symptoms of Benign Prostatic Hyperplasia: A NICE Medical Technology Guidance Update

Author

Listed:
  • Laura Knight

    (Cedar, Cardiff and Vale University Health Board)

  • Megan Dale

    (Cedar, Cardiff and Vale University Health Board)

  • Andrew Cleves

    (Cedar, Cardiff and Vale University Health Board)

  • Charlotte Pelekanou

    (National Institute for Health and Care Excellence)

  • Rhys Morris

    (Cedar, Cardiff and Vale University Health Board)

Abstract

Lower urinary tract symptoms (LUTS) commonly occur as a consequence of benign prostatic hyperplasia (BPH), also known as prostate enlargement. Treatments for this can involve electrosurgical removal of a section of the prostate via transurethral resection of the prostate (TURP), Holmium laser enucleation of the prostate (HoLEP), or prostatic urethral lift using the UroLift system. The UroLift system implants to pull excess prostatic tissue away so that it does not narrow or block the urethra. In this way, the device is designed to relieve symptoms of urinary outflow obstruction without cutting or removing tissue. National guidance recommending the use of UroLift in the UK NHS was first issued in 2015 by the National Institute for Health and Care Excellence (NICE MTG26). We now report on the process to update the economic evaluation of UroLift, leading to updated NICE guidance published in May 2021 (NICE MTG58). The conclusions of the available clinical evidence were mixed and suggested that whilst UroLift improves symptoms over time, this improvement is smaller than that of TURP for symptom severity (IPSS) and urological outcomes. However, UroLift appears to be superior to Rezum for symptom severity and measures of erectile dysfunction and ejaculatory dysfunction. The updated economic model estimated that using UroLift as a day-case procedure for people with prostate of volume 30–80 mL creates a saving of £981 per person compared with bipolar TURP, £1242 compared with monopolar TURP, and £1230 compared with HoLEP.

Suggested Citation

  • Laura Knight & Megan Dale & Andrew Cleves & Charlotte Pelekanou & Rhys Morris, 2022. "UroLift for Treating Lower Urinary Tract Symptoms of Benign Prostatic Hyperplasia: A NICE Medical Technology Guidance Update," Applied Health Economics and Health Policy, Springer, vol. 20(5), pages 669-680, September.
    • Handle: RePEc:spr:aphecp:v:20:y:2022:i:5:d:10.1007_s40258-022-00735-y
    DOI: 10.1007/s40258-022-00735-y
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    References listed on IDEAS

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    1. Alistair Ray & Helen Morgan & Antony Wilkes & Kimberley Carter & Grace Carolan-Rees, 2016. "The Urolift System for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: A NICE Medical Technology Guidance," Applied Health Economics and Health Policy, Springer, vol. 14(5), pages 515-526, October.
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