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UroLift — Prostatic Urethral Lift (PUL) for BPH

The UroLift system (Teleflex, originally NeoTract) is an FDA-cleared minimally invasive treatment for LUTS secondary to BPH that uses permanent nitinol–stainless-steel implants to mechanically retract obstructive prostatic lobes and widen the urethral lumen without cutting, heating, or removing tissue.[1][2][26] Among BPH MISTs it is the implant-based option. Rezūm is thermal, Aquablation uses hydroablation, Optilume BPH is a drug-coated balloon, iTIND is a temporary nitinol device, and TURP and HoLEP resect or enucleate tissue. The AUA 2026 guideline states that clinicians should offer PUL for prostates of 30 to 80 cc without an obstructing median lobe .[23] For positioning against other BPH options, see BPH & Male LUTS — chooser.

Mechanism of action​

Each UroLift implant is a double-ended hook with three components[1]:

  • Super-elastic nitinol capsular tab (anchors on the prostatic capsule)
  • Polyethylene-terephthalate monofilament (transcapsular tether)
  • Stainless-steel urethral end piece (anchors on the urethral surface)

The delivery device deploys a fine needle through the prostatic lobe; the capsular tab anchors on the outer prostatic capsule and the urethral piece on the urethral surface. Tensioning compresses the obstructing lobe away from the urethra, opening the lumen.[1] Unlike the other BPH MISTs, PUL is not ablative, resective or drug-eluting, and the implants are permanent.

Procedure​

PUL can be performed under local anesthesia with oral or IV sedation; general or spinal anesthesia is also used.[1][3] The device precautions below follow the UL400/ATC IFU; UroLift 2 uses a single-patient handle with separate implant cartridges and a different deployment sequence.[24][37] Mean procedure time in L.I.F.T. was 66.2 ± 23.8 minutes.[4] The procedure has these steps:

  1. Perform preprocedure cystoscopy with a 20 Fr rigid cystoscope assembly using a 2.9 mm 0° telescope and visual obturator. Inspect the urethra and bladder, then locate the prostatic fossa from bladder neck to verumontanum before implant placement.[24]
  2. The implant delivery device is angled anterolaterally to compress the obstructive lobe.
  3. Typically, 4–6 implants are placed, with the number adapted to anatomy; the UL400/ATC IFU recommends a maximum of 10. For lateral lobes, position the tip in the anterior prostate at 2–3 or 9–10 o'clock and place implants at approximately 1 cm intervals along both lobes, generally paired left and right, starting 1.5 cm distal to the bladder neck. A multinational retrospective series of 102 men used a mean of 4.5 implants per case.[24][3]
  4. Between and after implant deployments, perform cystoscopy of the urethra and bladder to confirm the urethral opening and tissue apposition, check for implants in the bladder or extending into it from the bladder neck, assess the trigone and bladder for injury, and remove improperly placed or poorly apposed components if required.[24]
  5. Assess voiding before discharge when a voiding trial is planned; catheter placement follows the trial result or local protocol. In L.I.F.T., 68/100 men offered a voiding trial avoided a postoperative catheter.[4]

Device precautions (US UL400/ATC IFU)​

The device should not be used with prostate volume >100 cc, urinary tract infection, current gross hematuria, incompetent-sphincter incontinence or a urethral condition preventing device passage; the IFU also warns against use with known nickel, titanium or stainless-steel allergy. For lateral-lobe placement, start 1.5 cm distal to the bladder neck and space implants approximately 1 cm apart. Deployment <1 cm from the bladder neck may expose an implant to the bladder and cause encrustation.[24] For median-lobe placement, the US UL400/ATC IFU warns against implanting the capsular tab posterior to the 4 and 8 o'clock positions on the prostatic capsule to avoid adjacent neurovascular and gastrointestinal structures.[24] If intravesical median-lobe tissue cannot be brought into the prostatic fossa, do not deploy an implant.[24]

Patient selection​

The L.I.F.T. pivotal trial enrolled men who met these criteria[4]:

  • Men ≥ 50 years in L.I.F.T.; the US UL400/ATC indication starts at age 45 years.[4][24]
  • IPSS ≥ 13
  • Qmax ≤ 12 mL/s in L.I.F.T.; BPH6 allowed ≤ 15 mL/s.[4][9]
  • Prostate volume 30–80 mL in L.I.F.T.; the UroLift IFU indicates use through 100 cc.[4][24]
  • PVR ≤ 250 mL and no urinary retention in L.I.F.T.[4]

In PULSAR, a prospective single-arm study of 52 catheter-dependent men after a failed voiding trial on an alpha-blocker, 38/52 were catheter-free at 12 months and eight underwent another BPH operation; obstructive median lobes and atonic bladders were excluded.[38] For catheter-dependent urinary retention attributed to BPH, the AUA 2026 guideline recommends resective technologies, taking comorbidities into account .[23]

Median lobe — the MedLift extension​

The original L.I.F.T. trial excluded obstructive median lobes; the US UL400/ATC device indication includes median-lobe hyperplasia, while the AUA and EAU recommendations below remain narrower.[4][24][23][22] MedLift was a non-randomized cohort of 45 men with obstructive middle lobes, compared with historical L.I.F.T. results, and later observational reports describe feasibility in selected median-lobe anatomy. Their authors are affiliated with the manufacturer.[6][7] The AUA 2026 statement applies to prostates without an obstructing middle lobe, whereas the EAU 2026 recommendation requires no middle lobe, and EAU notes that data on obstructed or protruding middle lobes are limited.[23][22]

Clinical efficacy​

L.I.F.T. — pivotal RCT​

A total of 206 men were randomized 2:1 (PUL versus sham) at 19 North American / Australian centers[4][8]:

  • 3-month primary endpoint (blinded): IPSS −11.1 (PUL) versus −5.9 (sham), p = 0.003, an 88% greater improvement.[4][8]
  • 12-month paired results: IPSS from 22.13 to 11.52 (n = 123); Qmax +4.03 mL/s (n = 102).[41]
TimepointIPSS ΔQoL ΔBPHII ΔQmax Δ
3 mo−11.1 (50%)——+4.4 mL/s[4][8]
12 mo−10.6 (47%; paired per-protocol)——+4.0 mL/s[8]
24 mo−9.1 (41%; paired per-protocol)——+4.2 mL/s[8]
5 yr−7.6 (36%; paired per-protocol, n = 72)50%52%+3.5 mL/s (44%; paired n = 52)[8]

In the treated cohort, IPSS improvement persisted but declined from 47% at 1 yr (123 paired observations) to 36% at 5 yr (72 paired observations) in the per-protocol analysis.[8] The EAU 2026 guideline reports 5-year improvement of 36% in IPSS, 50% in QoL and 44% in Qmax.[22] After the 3-month sham comparison the trial was uncontrolled.

BPH6 — PUL vs TURP RCT​

80 men, 10 European centers, 24-month follow-up[9][10]:

  • Both arms achieved significant IPSS improvement.
  • TURP produced greater IPSS reduction and Qmax improvement.
  • PUL was superior for quality of recovery and ejaculatory function preservation at 12 months (p < 0.01), and on the composite BPH6 responder endpoint.[9] The trial was non-blinded and small. In a 2026 network meta-analysis of 36 RCTs (4,851 men), PUL had higher 12-month PVR than bipolar TURP (mean difference 67.47 mL, 95% credible interval 11.02–125.79), while the MSHQ-EjD function score favored PUL over monopolar/bipolar TURP (mean difference 4.99 points, 95% credible interval 1.32–8.64); no statistically significant difference in ejaculatory bother was detected.[25]

Multinational real-world​

A retrospective single-arm series of 102 men at 7 centers in 5 countries placed a mean of 4.5 implants. Among paired observations at 12 months, IPSS improved 52% (n = 51), QoL 53% (n = 43) and Qmax 51% (n = 41; each p < 0.001); four of the 102 men underwent TURP for insufficient improvement by 11 months.[3]

Sexual function preservation — PUL's strongest signal​

Erectile and ejaculatory function are preserved after PUL in the trials and pooled analyses below.[4][8][11][12][13]

  • The L.I.F.T. reports observed no de novo sustained erectile dysfunction adverse events through 5 years of follow-up.[4][8]
  • The L.I.F.T. reports observed no de novo sustained ejaculatory dysfunction adverse events through 5 years of follow-up.[4][8]
  • The Franco 2026 Eur Urol pooled MIST analysis, as corrected in a published corrigendum, reported anejaculation of 0% with PUL, Optilume and iTIND, 3% with Rezūm and 5% with TPLA.[11][28]
  • In the Light 2021 Eur Urol network meta-analysis (48 papers, 33 RCTs, 5,159 patients, 16 interventions), PUL ranked highest for erectile function at 1, 6, 12 and 24 months versus monopolar TURP, and reached significance at 24 months (MD 3.63, 95% CrI 0.14–7.11). The authors noted that direct evidence is lacking.[12]
  • In the Cahill 2026 systematic review and meta-analysis (77 studies, 11,477 patients), IIEF scores improved significantly after PUL and Rezūm. PUL improved both MSHQ-EjD function and bother scores, and Rezūm improved only the bother score.[13]
  • In the combined MedLift and L.I.F.T. lateral-lobe dataset, ≥ 40% of sexually active men improved by the MCID for erectile function through 12 months.[6]

Safety profile​

Adverse events in L.I.F.T. were typically mild and transient.[1][4][14] The Cochrane review (Jung 2019) found that PUL likely increases minor adverse events versus sham at 3 months (RR 1.69, 95% CI 1.33–2.16; moderate certainty) and was uncertain about major adverse events.[1]

Common adverse events are dysuria, hematuria, pelvic pain and urgency, which are mostly mild to moderate and resolve within 2 to 4 weeks (EAU 2026 lists hematuria 16–63%, dysuria 25–58%, pelvic pain 5–17.9%, urgency 7.1–10%, transient incontinence 3.6–16% and UTI 2.9–11%).[22] In L.I.F.T., 40/140 treated men received a catheter by site protocol; 68/100 of the others avoided catheterization after a voiding trial.[4] Participants returned to preoperative physical activity in a mean of 8.6 days.[8]

Real-world signal — FDA MAUDE database​

MAUDE reports identify uncommon but potentially serious events, including hematoma and hematuria requiring hospitalization.[15] In Porto 2023, 23% of 226 UroLift reports and 7% of 358 Rezūm reports were classified as major.[15] The separate Weiss report likewise describes a selected reporting dataset.[16] MAUDE lacks exposure denominators and complete, verified event capture.

Retreatment and durability — the central limitation​

Clinical trial data:

  • L.I.F.T.: cumulative surgical retreatment for recurrent LUTS was 10.7% at 3 yr and 19/140 (13.6%) at 5 yr.[8][1] The five-year report also describes removal of encrusted implants in 10 men and prophylactic removal of exposed implants in three; isolated removal without additional implants or tissue resection was outside the recurrent-LUTS count.[8]
  • BPH6: secondary treatment for recurrent LUTS occurred in 3/44 PUL patients (6.8%) versus 2/35 TURP patients (5.7%) by 1 yr[1][9] and in 6/44 (13.6%) versus 2/35 (5.7%) by 2 yr.[10] The endpoint included additional PUL, intradetrusor botulinum toxin, laser treatment, or TURP.[9][10]

Meta-analysis (Miller 2020 J Urol) of 11 studies and 2,016 patients[17]:

  • The annual surgical reintervention rate was 6.0% per year (95% CI 3.0–8.9), and higher in studies with longer follow-up.[17]
  • Among 153 surgical reinterventions, the most common types were TURP / laser (51%), repeat PUL (32.7%) and device explant (19.6%).[17]

Real-world data report higher retreatment:

SourcePopulation / databaseRetreatment finding
Helman 2025 J Endourol[18]MarketScan, 10,938 commercially insured men across procedures (age at diagnosis 35–65 yr)5-yr surgical retreatment 22.3% for PUL (vs 7% HoLEP, 24.5% TUMT). 1-yr medical retreatment also higher after MIST vs traditional procedures (42.9% vs 27.3%)
Raizenne 2022[19]NY / CA population study, 2,694 men (PUL, TUNA, TUMT)1-yr and 3-yr reoperation 5.5% and 14.9% after PUL, with no significant difference from TUNA or TUMT
Gaffney 2021[20]Premier Healthcare, 175,150 menPUL OR 1.78 for retreatment within 2 years vs TURP / photovaporization (p < 0.01)
Shin 2024 BJU Int NMA[21]12-month reintervention NMA of new BPH interventionsRanking at 12 months: TURP, Aquablation, iTIND, Rezūm, then UroLift
Feiertag TriNetX analysis, as summarized in the AUA 2026 guideline[23]Claims databaseCumulative re-procedure 5.1% at 1 yr and 16.1% at 4 yr, vs 7.5% after TURP and 7.8% after PVP at 4 yr. EAU 2026 cites the same 4-year figures and adds an annual reintervention rate of 6% per year (95% CI 3.0–8.9) in a systematic review of 11 studies[22]

Guideline status​

AUA 2026. Clinicians should offer PUL as an option for prostates of 30 to 80 cc without an obstructing median lobe .[23] Before PUL, clinicians should counsel that it implants permanent tines that may affect future procedures and future prostate imaging .[23] The 2023 amendment used the same volume and median-lobe criteria.[5]

EAU 2026. Offer PUL to men with LUTS/BPO who want to preserve ejaculatory function, with a prostate < 70 mL and no middle lobe . Advise that retreatment rates are higher after PUL than after TURP . EAU rates the higher retreatment risk as level 3 evidence and the inferiority to TURP at 24 months as level 1b.[22] See the BPH & Male LUTS chooser for the full 2026 AUA framework.

Comparison with other MISTs​

ProcedureReported IPSS changeReported Qmax changeStudied volume rangeMedian lobe evidenceImplant left?Retreatment context
UroLift (PUL)−11.1 at 3 mo (about 50%)[4]+4.0 mL/s at 12 mo[4]30–80 mL in L.I.F.T.; IFU excludes >100 cc[4][24]Selected MedLift median-lobe cohort; guideline restrictions above[6]Permanent nitinol / steel implants[24]22.3% surgical retreatment at 5 yr (MarketScan)[18]
Rezūm−11.3 at 3 mo (pivotal treatment arm)[29]+5.6 mL/s at 12 mo (pivotal treatment arm)[29]30–80 mL in pivotal trial; US FDA indication 30–150 mL since 2025[29][40]TreatableNone4.4% surgical retreatment at 5 yr (pivotal trial)[29]
iTIND−9.3 at 12 mo (RCT)[33] / −13.7 at 12 mo (single-arm)[34]+3.5 mL/s at 12 mo (RCT)[33] / 7.3 to 14.7 mL/s at 12 mo (single-arm)[34]25–75 mL (RCT)[33]; <75 mL (single-arm)[34]ExcludedNone (device removed)5% retreatment at 3 yr (EAU 2026)[22]
Optilume BPH−11.5 at 1 yr[35]+10.3 mL/s at 1 yr[35]20–80 g[35]Intravesical protrusion above 1 cm excluded; smaller protrusion included[42]NoneNot yet 5-yr
Aquablation−15.1 at 12 mo (WATER)[30]+10.3 mL/s at 12 mo (WATER)[30]30–80 mL (WATER); 80–150 mL (WATER II)[30][31]TreatableNone4.1% pooled reoperation at 5 yr (2 studies)[32]
TURP−15.1 at 12 mo (WATER)[30]+10.6 mL/s at 12 mo (WATER)[30]up to 80 mL in WATER[30]TreatableNone7.7% pooled reoperation at 5 yr (He 2023)[32]

Where UroLift fits​

Distinguishing advantages​

  • In L.I.F.T., 68/100 men offered a postoperative voiding trial avoided a catheter; 40/140 treated men received one by site protocol.[4]
  • Erectile and ejaculatory function are preserved, with 5-year follow-up from L.I.F.T.
  • It can be performed under local anesthesia in the office.
  • The AUA 2026 guideline lists HoLEP, ThuLEP, PVP or PAE, not PUL, for patients at high bleeding risk or on anticoagulants.
  • Obstructive median lobes have been treated in MedLift and later observational reports, but AUA and EAU recommendations exclude them.
  • Quality of recovery was better than after TURP in BPH6, and return to activity averages about 9 days.
  • Later TURP, laser vaporization, HoLEP and repeat PUL remain possible after PUL.[24][39] Retained clips can jam the morcellator during HoLEP; a three-patient technical series reported blade replacement in two cases and noted that remnant clips and sutures can be retrieved with a grasper.[39] UroLift implants can impair later prostate MRI quality.[27]

Principal limitations​

  • Five-year surgical retreatment of 22.3% in MarketScan, second only to TUMT (24.5%) among the procedures compared.[18]
  • At 12 months, Qmax increased +4.0 mL/s in the L.I.F.T. PUL arm[4], +4.6 mL/s in a Rezūm pilot cohort[36], +10.3 mL/s in the PINNACLE Optilume BPH arm[35], and +10.3 mL/s with Aquablation versus +10.6 mL/s with TURP in WATER[30].[4][36][35][30]
  • Permanent implants in the body (versus iTIND's reversible reshape-and-remove or Optilume's non-implant approach).
  • Prostate size thresholds differ: L.I.F.T. enrolled men with 30–80 mL prostates[4]; the EAU guideline strongly recommends offering PUL to men interested in preserving ejaculation with prostates <70 mL and no middle lobe[22]; and the UroLift IFU contraindicates use above 100 cc.[24] For larger glands, consider Aquablation, Simple Prostatectomy, or PAE.[4][22][24]
  • FDA MAUDE reports describe hematoma and hematuria requiring hospitalization.
  • In paired per-protocol L.I.F.T. observations, IPSS improvement attenuated from 47% at 1 yr (n = 123) to 36% at 5 yr (n = 72).[8]

Imaging consideration for the reconstructive urologist​

UroLift implants are visible on CT as paired metallic densities in the prostatic urethra and capsule. The stainless-steel urethral end piece creates MRI artifact. The US UL400/ATC IFU labels the implant MR Conditional for scanning at ≤3.0 T, a maximum spatial gradient of ≤1,500 Gauss/cm, and MR system-reported whole-body averaged SAR of ≤4 W/kg for 15 minutes per pulse sequence (First Level Controlled Operating Mode).[24] In a single-center retrospective study of 37 patients, all had artifact, which affected diffusion-weighted images more than T2-weighted images; artifact obscured a mean 32% of the gland on diffusion-weighted images, and 16–24% of examinations had suboptimal image quality.[27] Men who may need prostate MRI for cancer workup should be counseled about this limitation before implantation.[23][27]

See Also​

BPH & Male LUTS — chooser · Rezūm · iTIND · Optilume BPH · Prostate Artery Embolization · Simple Prostatectomy · Prostate Enucleation / HoLEP · UroLift device profile

References​

1. Jung JH, Reddy B, McCutcheon KA, et al. Prostatic urethral lift for the treatment of lower urinary tract symptoms in men with benign prostatic hyperplasia. Cochrane Database Syst Rev. 2019;5:CD012832. doi:10.1002/14651858.CD012832.pub2

2. Franco JV, Jung JH, Imamura M, et al. Minimally invasive treatments for lower urinary tract symptoms in men with benign prostatic hyperplasia: a network meta-analysis. Cochrane Database Syst Rev. 2021;7:CD013656. doi:10.1002/14651858.CD013656.pub2

3. McNicholas TA, Woo HH, Chin PT, et al. Minimally invasive prostatic urethral lift: surgical technique and multinational experience. Eur Urol. 2013;64(2):292-299. doi:10.1016/j.eururo.2013.01.008

4. Roehrborn CG, Gange SN, Shore ND, et al. The prostatic urethral lift for the treatment of lower urinary tract symptoms associated with prostate enlargement due to benign prostatic hyperplasia: the L.I.F.T. study. J Urol. 2013;190(6):2161-2167. doi:10.1016/j.juro.2013.05.116

5. Sandhu JS, Bixler BR, Dahm P, et al. Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia (BPH): AUA Guideline Amendment 2023. J Urol. 2024;211(1):11-19. doi:10.1097/JU.0000000000003698

6. Rukstalis D, Grier D, Stroup SP, et al. Prostatic urethral lift (PUL) for obstructive median lobes: 12 month results of the MedLift study. Prostate Cancer Prostatic Dis. 2019;22(3):411-419. doi:10.1038/s41391-018-0118-x

7. Eure G, Rukstalis D, Roehrborn C. Prostatic urethral lift for obstructive median lobes: consistent results across controlled trial and real-world settings. J Endourol. 2023;37(1):50-59. doi:10.1089/end.2022.0324

8. Roehrborn CG, Barkin J, Gange SN, et al. Five year results of the prospective randomized controlled prostatic urethral L.I.F.T. study. Can J Urol. 2017;24(3):8802-8813. PMID 28646935

9. Sønksen J, Barber NJ, Speakman MJ, et al. Prospective, randomized, multinational study of prostatic urethral lift versus transurethral resection of the prostate: 12-month results from the BPH6 study. Eur Urol. 2015;68(4):643-652. doi:10.1016/j.eururo.2015.04.024

10. Gratzke C, Barber N, Speakman MJ, et al. Prostatic urethral lift vs transurethral resection of the prostate: 2-year results of the BPH6 prospective, multicentre, randomized study. BJU Int. 2017;119(5):767-775. doi:10.1111/bju.13714

11. Franco A, Ditonno F, Manfredi C, et al. Systematic review and pooled analysis of functional and sexual outcomes of minimally invasive surgical treatments for benign prostatic obstruction. Eur Urol. 2026;89(4):318-331. doi:10.1016/j.eururo.2025.09.004

12. Light A, Jabarkhyl D, Gilling P, et al. Erectile function following surgery for benign prostatic obstruction: a systematic review and network meta-analysis of randomised controlled trials. Eur Urol. 2021;80(2):174-187. doi:10.1016/j.eururo.2021.04.012

13. Cahill EM, Lindenbaum MM, Estright A, et al. The impact of minimally invasive surgical therapy for benign prostatic hyperplasia on sexual function: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis. 2026. doi:10.1038/s41391-026-01091-x

14. Cantwell AL, Bogache WK, Richardson SF, et al. Multicentre prospective crossover study of the 'prostatic urethral lift' for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia. BJU Int. 2014;113(4):615-622. doi:10.1111/bju.12540

15. Porto JG, Arbelaez MCS, Blachman-Braun R, et al. Complications associated with minimally invasive surgical therapies (MIST) for surgical management of benign prostatic hyperplasia: a Manufacturer and User Facility Device Experience (MAUDE) database review. World J Urol. 2023;41(7):1975-1982. doi:10.1007/s00345-023-04440-w

16. Weiss JK, Santucci NM, Sajadi KP, Chouhan JD. Post-surgical complications after bladder outlet reducing surgery: an analysis of the FDA Manufacturer and User Facility Device Experience (MAUDE) database. Urology. 2021;156:211-215. doi:10.1016/j.urology.2021.04.030

17. Miller LE, Chughtai B, Dornbier RA, McVary KT. Surgical reintervention rate after prostatic urethral lift: systematic review and meta-analysis involving over 2,000 patients. J Urol. 2020;204(5):1019-1026. doi:10.1097/JU.0000000000001132

18. Helman T, Patil D, Marthi S, Browne B. Impact of endoscopic bladder outlet procedures on medical and surgical retreatment: a large population analysis. J Endourol. 2025;39(6):608-616. doi:10.1089/end.2024.0741

19. Raizenne BL, Zheng X, Mao J, et al. Real-world data comparing minimally invasive surgeries for benign prostatic hyperplasia. World J Urol. 2022;40(5):1185-1193. doi:10.1007/s00345-021-03926-9

20. Gaffney CD, Basourakos SP, Al Hussein Al Awamlh B, et al. Adoption, safety, and retreatment rates of prostatic urethral lift for benign prostatic enlargement. J Urol. 2021;206(2):409-415. doi:10.1097/JU.0000000000001757

21. Shin BNH, Qu L, Rhee H, Chung E. Systematic review and network meta-analysis of re-intervention rates of new surgical interventions for benign prostatic hyperplasia. BJU Int. 2024;134(2):155-165. doi:10.1111/bju.16304

22. European Association of Urology. EAU Guidelines on the Management of Non-neurogenic Male LUTS. 2026. Official full guideline. See section 5.3.5.a.

23. Goueli R, Badlani GH, Welliver C, et al. Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia (BPH): AUA guideline (2026). Part III: Procedural and surgical management. J Urol. 2026;216(2):161-170. doi:10.1097/JU.0000000000005099

24. NeoTract, Inc. UroLift System UL400 and UroLift ATC System Instructions for Use, US. L00169-01 Rev B; 2020. Official IFU.

25. Godinho NJS, de Miranda Onofre JC, Colhado CH, et al. "Minimally invasive treatments for benign prostatic obstruction: a systematic review and network meta-analysis of randomized controlled trials at 12 months." Int Urol Nephrol. Published online August 24, 2026. doi:10.1007/s11255-026-05346-3

26. US Food and Drug Administration. 510(k) substantial equivalence determination: UroLift System (UL400), K193269. 2019. FDA decision.

27. Benidir T, Austhof E, Ward RD, et al. "Impact of prostate urethral lift device on prostate magnetic resonance image quality." J Urol. 2023;209(4):752-761. doi:10.1097/JU.0000000000003156

28. Franco A, Ditonno F, Manfredi C, et al. "Corrigendum to 'Systematic review and pooled analysis of functional and sexual outcomes of minimally invasive surgical treatments for benign prostatic obstruction' [Eur. Urol. 89 (2026) 318–331]." Eur Urol. 2026;90(2):185. doi:10.1016/j.eururo.2026.05.003

29. McVary KT, Gittelman MC, Goldberg KA, et al. "Final 5-Year Outcomes of the Multicenter Randomized Sham-Controlled Trial of a Water Vapor Thermal Therapy for Treatment of Moderate to Severe Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia." J Urol. 2021;206(3):715-724. doi:10.1097/JU.0000000000001778

30. Gilling PJ, Barber N, Bidair M, et al. "Randomized Controlled Trial of Aquablation versus Transurethral Resection of the Prostate in Benign Prostatic Hyperplasia: One-year Outcomes." Urology. 2019;125:169-173. doi:10.1016/j.urology.2018.12.002

31. Bhojani N, Bidair M, Kramolowsky E, et al. "Aquablation Therapy in Large Prostates (80-150 mL) for Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: Final WATER II 5-Year Clinical Trial Results." J Urol. 2023;210(1):143-153. doi:10.1097/JU.0000000000003483

32. He W, Ding T, Niu Z, et al. "Reoperation after surgical treatment for benign prostatic hyperplasia: a systematic review." Front Endocrinol. 2023;14:1287212. doi:10.3389/fendo.2023.1287212

33. Chughtai B, et al. "The iTind Temporarily Implanted Nitinol Device for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: A Multicenter, Randomized, Controlled Trial." Urology. 2021;153:270-276. doi:10.1016/j.urology.2020.12.022

34. Porpiglia F, et al. "Second-generation of temporary implantable nitinol device for the relief of lower urinary tract symptoms due to benign prostatic hyperplasia: results of a prospective, multicentre study at 1 year of follow-up." BJU Int. 2019;123(6):1061-1069. doi:10.1111/bju.14608

35. Kaplan SA, et al. "The PINNACLE Study: A Double-blind, Randomized, Sham-controlled Study Evaluating the Optilume BPH Catheter System for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia." J Urol. 2023;210(3):500-509. doi:10.1097/JU.0000000000003568

36. Dixon CM, et al. "Efficacy and Safety of Rezūm System Water Vapor Treatment for Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia." Urology. 2015;86(5):1042-1047. doi:10.1016/j.urology.2015.05.046

37. NeoTract, Inc. UroLift 2 System Instructions for Use, US. L00127-01 Rev E; June 2022. Official IFU

38. Rochester M, Doherty R, Page T, et al. "Prostatic urethral lift for subjects in urinary retention (PULSAR): 12-month results of a prospective controlled trial compared with real-world outcomes." BJUI Compass. 2024;5(1):60-69. doi:10.1002/bco2.280

39. Parikh KA, Dora CD. "Holmium laser enucleation of the prostate after failed UroLift: surgical considerations for the management of nonabsorbable implants." Urology. 2019;132:212. doi:10.1016/j.urology.2019.06.027

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