The Urolift Procedure What You Can Expect
One of our specially trained urologists will perform the UroLift procedure. This outpatient procedure is typically performed in the physicians office under local anesthesia.
The procedure involves the following steps:
Recommended Reading: How Do You File For Medicare
What Is A Urolift Procedure
A UroLift procedure is an FDA-approved minimally invasive treatment in which implants are used to hold the enlarged prostate out of the way, treating symptoms of BPH.
Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.
How Can Treatment For Enlarged Prostate Be Made More Affordable
The least expensive option for treatment for enlarged prostate is taking medication such as Flomax and finasteride, which can cost less than $200-300 per year. When these medications do not work well, office procedures such as Rezum and Urolift as well as laser prostate enucleation, Greenlight laser and bipolar TURP are also very effective in treating symptoms of an enlarged prostate. Some patients have intolerable side effects to medications and require medication-free options.
Procedures such as the Rezum procedure and Urolift procedure for enlarged prostate can improve the slow urine stream, incomplete bladder emptying, urge to pee and wake up at night to urinate. The choice of which procedure is best for you is usually decided between you and your urologist after consultation at New York Urology Specialists.
For patients who cannot afford the cost of treatment for enlarged prostate and urinary retention, affordable financing options are available including no interest or low-interest rate credit cards, CareCredit, and installment payments.
You May Like: How To Change Medicare Direct Deposit
Also Check: Does Social Security Pay For Medicare Part B
Insurance Coverage For Urolift Procedure
Medicare and many other . If you are interested in the Urolift procedure, please schedule an evaluation. If you are a candidate for the Urolift procedure, we will request a coverage determination from your insurance company. Typically insurance companies require pre-authorization for a Urolift procedure. We cannot obtain preauthorization until the doctor has evaluated you and determined that you are a candidate for the Urolift procedure.
Did you know?Dr. Shteynshlyuger has performed over 1,000 surgeries and procedures for enlarged prostate, including Rezum, Urolift, prostate enucleation, laser ablation of the prostate, and TURP. He performs over 100 prostate procedures a year.
Recommended Reading: Does Medicare Cover Bone Grafts
Who Is A Good Candidate For The Urolift System Treatment
You may be a good candidate if you are a male, 45 years of age or older, and have symptoms relating to BPH. Speak with your urologist to see if the UroLift® System treatment is right for you. If you have a known allergy to nickel, titanium or stainless steel, talk to your doctor about your allergy before getting a UroLift System treatment.
Read Also: How Do I Submit Medical Bills To Medicare For Reimbursement
Read Also: How Do I Get Medicare Part C
Urolift Treatment For Urinary Relief
Prostatic Tissue Approximation The Urolift is a prosthesis that resembles a small suture connected to an anchor that is implanted under endoscopic guidance with the aim of retracting the prostatic urethra toward the prostatic capsule to open the prostatic urethral space.
It is constructed from two tabs, a stainless steel urethral tab and a nitinol capsular tab. A needle is deployed transurethrally beyond the prostatic capsule and delivers suture-based implants that are placed under tension . This mechanically retracts the prostatic lobes to open the prostatic urethral space. This procedure can be performed on an outpatient basis under local anesthetic block – which is really great because you can avoid going under general anesthesia and this can be done in the office.
Urolift has been found to have significantly lower morbidity than other surgical treatments surgical treatments for BPH-associated LUTS. Documented complications include hematuria, dysuria, and bladder spasms. An expanded Australian multicenter study was performed in 2012 that evaluated 64 patients who received the Urolift procedure with follow-up up to 2 years. This study found a reduction in IPSS scores from a mean baseline of 22.6 to 12.6 after 2 years. Peak flow rate at 2 years increased to 10.3 mL/s from a baseline of 7.4 mL/s. Re-treatment was necessary in 20% of men treated and included either photoselective vaporization of the prostate or TURP.
What Happens If The Implants Need To Be Removed
The implant is made up of standard surgical implantable materials: a nitinol capsular tab, a stainless steel urethral tab, and polyester suture that holds the two tabs together. Your doctor can simply remove the implant, if needed. The suture can be cut and the urethral endpiece can be retrieved with a standard grasper. The capsular tab will remain outside the prostate capsule in place.
Read Also: What Are All The Parts Of Medicare
Talking To Your Doctor About Bph
BPH is very common, dont be afraid to discuss your concerns with your doctor. If you are experiencing any of the mentioned symptoms, there are many treatment options that are available to you.
Before your doctors office visit, you can take thisBPH Symptom Quiz, designed by the American Urological Association, to determine the severity of your symptoms.
Schedule an appointment today with Bellingham Urology to discuss your BPH symptoms and your treatment options.
Here at Bellingham Urology Group, were proud to announce that weve been recognized as a UroLift Center of Excellence by UroLift.com. You can read more about it here.
Is The Treatment Permanent
The UroLift Implant is a permanent implant, and the treatment is intended to be permanent. Durability has been shown to at least 4 years in U.S. clinical data, and results will continue to be published as follow-ups continue. One unique aspect of the UroLift System is that it does not preclude retreatment or other BPH treatments, should that be needed and desired in the future.
You May Like: Is Allwell A Medicare Advantage Plan
What If My Health Insurance Company Has Denied Coverage For Rezm Water Vapor Therapy
If your health insurance company has denied coverage for Rezm Water Vapor Therapy, you may want to appeal the denial by following these steps:
- Contact your doctors office and ask if they will submit an appeal on your behalf.
- Contact your insurance company and ask to appeal the decision. They will be able to provide you with next step instructions.
- If you are enrolled in an employer-sponsored health plan, this guide and sample appeal letter may be helpful as you pursue coverage.
How Do The Costs Of Urolift Procedure Compare To Using Medications For The Treatment Of Enlarged Prostate
The most common medications for BPH and enlarged prostate are Flomax or Rapaflo. These medications are often used in combination with a medication such as Proscar . The typical out of pocket cost for these two medications runs $30-50 per month or $300-$500 per year over 5 years, the cost is more than $2,500. For patients with insurance and copay of $20 per prescription per month, the cost will run anywhere from $240 for one medication to $480 for 2 medications. Over the first five years, the cost would be expected to be $1200 to $2400. Medications are much less expensive than the Urolift procedure, but medications do not always work as well as does the Urolift procedure.
Don’t Miss: Which Medicare Plan Covers Prescription Medications
What Happens During The Pae Procedure
It works by placing a tiny catheter into the arteries that feed the prostate gland. A solution containing thousands of microscopic plastic beads is injected these block the blood supply by shutting down blood flow to the gland. All of this is accomplished through a tiny quarter-inch hole in the skin. General anesthesia is not needed because the procedure is not all that painful. Most patients go home the same day with just a small bandage, requiring only a few days of recovery at home before returning to normal life. Over time, the prostate gland is starved of its blood supply, and it shrivels up, like a grape shrinking into a raisin, says Dr. Ayyagari. This allows the urethra to open up and urine to flow more normally. Amazingly, shrinking the prostate does not have any negative impact on sexual function, and indeed a small number of patients actually experience an improvement in their sexual function after the procedure.
Cost Of Urolift Procedure: Considerations
There are two parts to consider when discussing the cost of the Urolift procedure.
The overall cost of the Urolift procedure is made up of a few components. The first part is a professional fee charged by the urologist performing the procedure. If the Urolift procedure is performed in the office settings, this charge will typically include facility costs, nursing costs, and supply costs used to perform the procedure.
If the procedure is performed in the hospital or surgical center, a is typically charged by the hospital or surgical center for facility use. In addition, another fee will be billed by the anesthesiologist for anesthesia.
It is obviously less expensive to have the procedure performed in the office under local anesthesia. You save on hospital facility fees, which can be anywhere from $3,000-$15,000. You also save on the anesthesiologist fee.
The other cost consideration is the actual cost of Urolift implants. A typical patient will need anywhere from 6-8 Urolift implants. Some patients may require more than 6 Urolift implants to be placed during the procedure to obtain the maximum benefit. These implants are fairly costly, with an overall cost close to $1000 for each implant.
You May Like: What Is Medicare Advantage Otc Card
Read Also: What Is Not Covered By Medicare Part A And B
What Is The Urolift System
Treatment with the UroLift® System uses a minimally invasive approach that provides rapid relief and recovery of BPH symptoms. It is an earlier treatment option that can get men off BPH medications and avoid major surgery. The goal of the UroLift System treatment is to relieve symptoms so you can get back to your life and resume your daily activities. The UroLift® System treatment has demonstrated a significant improvement in quality of life for patients that is greater than reported for medications. The UroLift® System is the only BPH procedure shown not to cause new and lasting erectile or ejaculatory dysfunction*, while being a safe and effective treatment of lower urinary tract symptoms due to BPH.
What Are The Benefits Of Urolift
Many men with BPH use medicines to control symptoms. However, these medicines can cause side effects like dizziness, nasal congestion and sexual dysfunction. These medicines also stop working when the man stops taking them, which means many men must choose between unpleasant side effects or BPH symptoms.With the UroLift®, patients dont experience these unpleasant side effects, and most men notice BPH symptoms go away within 30 days. Studies have also shown that the UroLift® has fewer side effects compared to transurethral resection of the prostate , which is a surgical procedure used to treat BPH. TURP can cause side effects like sexual dysfunction and incontinence. Because of where the UroLift® implants are placed on the prostate, they are less likely to damage nerves and cause these problems.The UroLift® procedure also has a faster recovery time compared to TURP and usually doesnt require a catheter .
Recommended Reading: When Do I Receive Medicare
New Treatment Can Help Men With An Enlarged Prostate
There are three main types of problems that occur with the prostate. The first involves prostate infections or painful prostate conditions. The second involves benign prostatic hyperplasia , or overgrowth of the prostate that occurs as men age beyond their 30s. The third category of prostate problems is prostate cancer. One of these categories of problems does not lead to a problem in another category. In other words, there is not a cause-effect relationship between having an enlarged prostate or an infected prostate and prostate cancer.
It is perfectly normal for a mans prostate to enlarge. In fact, it is an expected part of aging. The prostate can enlarge or expand in size outward and/or inward. The patient can have a really big enlarged prostate and not have any urination difficulties or a patient can have a mildly enlarged prostate and need an operation. Everybody is different.
Treatment
If a man begins to have symptoms of having an enlarged prostate, we have several options in managing it. Historically, surgery was the only answer.
Ten to 15 percent of patients who have a TURP require other therapy at some point in their lives. With the lesser tissue removal procedures, more patients need something done at another point in their lives than with a TURP.
The new procedure
Find more information about an enlarged prostate at
Advantages of the UroLift System:
How the UroLift works:
How the UroLift System Works
How Does The Urolift System Work
The UroLift® System uses a revolutionary approach to treating BPH that lifts and holds the enlarged prostate tissue so it no longer blocks the urethra. It is the only available BPH treatment performed by a urologist that does not require heating, cutting, or removal of the prostate tissue. The procedure is typically performed using local anesthesia in a physicians office or ambulatory surgery center. Patients typically return home the same day without a catheter.
*No instances of new, sustained erectile or ejaculatory dysfunction
Recommended Reading: Can You Qualify For Medicaid If You Have Medicare
Payor Coverage Policy Lookup Tool
To be redirected to the UroLift System online Payor Coverage Policy Lookup Tool, to search insurance coverage for the UroLift System.
Teleflex LLC encourages providers to submit claims for services that are appropriately and accurately consistent with FDA clearance and approved labeling and does not promote the use of its products outside their FDA-cleared labeling.
Fda Approved Bph Treatment
The UroLift® System treatment is a revolutionary, minimally invasive approach to treating an enlarged prostate, or BPH, that lifts or holds the enlarged prostate tissue out of the way so it no longer blocks the urethra. The goal of treatment is to relieve symptoms so you can get back to your life and resume your daily activities. There is no cutting, heating or removal of prostate tissue. The UroLift Procedure was FDA approved in 2013 and is backed by multiple clinical trials. Now, over 300,000 men have been treated with the Urolift System with more than 1.25 million Urolift implants. Medicare and most major commercial insurance plans cover the Urolift System treatment.
Clinical data has shown that the UroLift® System treatment is safe and effective in relieving lower urinary tract symptoms due to BPH without compromising sexual function
Also Check: Does Medicare And Medicaid Cover Dentures
An Alternative To Medications And Surgery To Treat Bph/enlarged Prostate
UroLift® is an FDA-approved, minimally invasive treatment for benign prostatic hyperplasia . The procedure involves lifting or holding the enlarged prostate tissue out of the way so it no longer blocks the urethra, relieving urinary symptoms. Permanent implants are inserted utilizing a special delivery device and act like window curtain tie-backs, holding the lobes of the enlarged prostate open to relieve obstruction of the urethra. There is no cutting, heating, or removal of prostate tissue involved. Most medical insurance providers, including all Medicare plans, cover the UroLift System treatment when medically necessary.
All Patients With Medicare Who Are Eligible For Urolift Can Be Treated
Medicare decided to cover the Urolift procedure after evaluating scientific studies that demonstrate excellent outcomes and very good safety of the procedure. Currently for men with enlarged prostate Medicare covers the cost of medications, Urolift procedure, Greenlight laser,Rezum procedure, HOLEP prostate enucleation, and TURP as well as open surgery for treatment of enlarged prostate.
The availability of Urolift procedure to patients with Medicare is an important milestone as men now have an additional treatment option for BPH that does not require medications and has no sexual side effects.
If you have any questions about the treatment of BPH with Urolift, to schedule a consultation with Dr. Shteynshlyuger, or if you need a second opinion for BPH, pleasecontact us.
Dr. Shteynshlyuger is a board-certified urologist and specialist in the treatment of enlarged prostate and complex urinary problems using minimally invasive approaches. He is the Director of Urology at New York Urology Specialists. He is one of the first urologists in the US and in New York City to offer Urolift as a treatment for enlarged prostate.
Medicare covers the cost of Urolift procedure for all eligible men who experience symptoms of an enlarged prostate. A proper evaluation is required, which may include bladder ultrasound, uroflow procedure, cystoscopy, and prostate ultrasound in addition to the PSA test.
Recommended Reading: Is Medicare For Old People
Good News For Men With No Insurance Or High Deductible: Urolift In Our Office Saves You $$$
New York Urology Specialists is a leader in offering Urolift procedure under local anesthesia. In fact, more than 80% of our patients have the Urolift procedure done in the office setting under local anesthesia whether they pay out-of-pocket or are covered by insurance.
The procedure takes 15 minutes to perform. Most men have minimal discomfort and can go home an hour after the procedure. Urolift in our office is safer than having the procedure done in a hospital, as our infection rates are lower, and there is no risk of general anesthesia.
This saves you a tremendous amount of money compared to what hospitals charge so much that hospitals wont tell you the price!
