Not every man with an enlarged prostate wants or needs a larger operation. For men with small to medium prostates, minimally invasive treatments can relieve symptoms with a quick recovery and a lower risk of sexual side effects. UroLift and iTind are two of these options. Both widen the urinary channel without cutting away prostate tissue.
Why minimally invasive options matter
Traditional operations such as TURP work well but often cause retrograde ejaculation, where semen flows back into the bladder. For many men, especially those who are sexually active, protecting ejaculation is a priority. Minimally invasive treatments aim to offer a middle path between tablets and surgery. They also tend to suit men who want to avoid a longer hospital stay, or who would find several weeks away from work or family commitments difficult.
How UroLift works
UroLift uses small implants to hold the enlarged lobes of the prostate apart, a bit like tie-backs on a curtain. A thin instrument is passed up the urethra, and each implant is placed through the prostate tissue to pull it away from the channel.
Key points:
- usually done as a day case, under local or general anaesthetic
- no tissue is removed or heated
- most men do not need a catheter afterwards
- designed to preserve ejaculation and erections
UroLift suits men with prostates of small to moderate size. It is not suitable for a prominent middle lobe in some cases. NICE has published guidance on UroLift for this group.
How iTind works
iTind is a temporary device made of nitinol, a flexible metal. It is folded and placed in the urethra at the prostate, where it gently expands. Over five to seven days, it applies steady pressure to reshape the channel. It is then removed completely.
Key points:
- placed and removed as short outpatient procedures
- nothing is left behind permanently
- no tissue is cut or heated
- designed to preserve ejaculation and erections
During the days it is in place, some men notice discomfort, urgency or a little blood in the urine. These usually settle once it is removed.
Comparing the two
- What stays in the body: UroLift leaves permanent implants. iTind leaves nothing behind.
- Treatment time: UroLift is completed in a single procedure. iTind involves placement and removal about a week apart.
- Prostate size: both suit small to moderate prostates.
- Recovery: both have a short recovery, with most men back to normal activity within days.
- Durability: both relieve symptoms for several years in many men, but some may need further treatment later.
Who may not be suitable
These options may not suit men with:
- a very large prostate
- a large middle lobe pressing into the bladder
- urinary retention needing a long-term catheter
- certain bladder problems
In these cases, treatments such as Aquablation therapy or prostate artery embolisation may be more suitable.
What recovery is like
Because no tissue is removed, recovery after either treatment is usually quick. Most men return to desk-based work within a few days. It is common to notice some urgency, stinging or a little blood in the urine at first, and these usually settle within a week or two. The full benefit on flow and symptoms may take a few weeks to appear.
Making the choice
The best treatment depends on prostate size and shape, symptom severity and your priorities about sexual function and recovery time. A flow test, bladder scan and prostate measurement will help guide the decision. The NHS guide to an enlarged prostate gives a summary of treatments.
Professor Prokar Dasgupta offers iTind and other treatments for an enlarged prostate at The London Clinic. Our page on benign prostatic enlargement explains the full range. Please contact the clinic to arrange a consultation.