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Minimal invasive management for the relief of LUTS (lower urinary tract symptoms)

Why is it done?

  • This procedure is performed when the prostate gland is causing LUTS and you want an alternative to medication without the complications of a permanent procedure.
  • Symptoms include a weak stream, nightly urination, frequent urination, inability to urinate, (LUTS) kidney failure due to the obstruction, bladder stones, recurrent bladder infections.
  • Medication such as Flomaxtra, Urorec, Minipress etc.  should always be given as a first resort.
  • This is alternative to medication where the ejaculatory function is to be preserved.
  • Prostate cancer first needs to be ruled out by doing a PSA, and when indicated, with a 3T MRI scan of the prostate with an abnormal PSA with a possible prostate biopsy of any suspicious lesions.
  • Usually, a trial of alpha-blockers would be attempted
  • Prostate sizes up to 80-100 cc with NO mid lobe.


How is it done?

  • Patients will receive general anaesthesia, unless contra-indicated.
  • A cystoscopy is performed by placing a camera in the urethra with the help of a  lubricant jelly and an irrigant fluid.
  • The inside of the bladder is viewed for pathology. If any suspicious lesions are seen, a biopsy will be taken.
  • The device is placed through the cystoscopic sheath.
  • Prostate lobes are drawn apart similar to opening a curtain.
  • Occasionally a Bladder Neck Incision may be done if the bladder neck is too narrow.
  • Prophylactic antibiotics will be given to prevent any infections.




  • Ejaculation will not be affected as with medication, TURP and TUVP, therefore no retrograde ejaculation, thus preserving sexual function
  • Fertility is not guaranteed. If it is an issue, DON’T DO IT!.
  • No Stress incontinence especially in the elderly and the diabetic patients
  • May experience a slower stream initially due to swelling
  • Some urgency symptoms
  • Possible infection due to cystoscopy (<2%)
  • Rare cases of stone formation on clips.
  • Further enlargement of prostate lobes within 3-5 years requiring a definite procedure.
  • NB! Each person is unique and for this reason, symptoms vary!


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Copyright 2019 Dr Jo Schoeman