Minimally invasive treatments for benign prostatic hyperplasia: A narrative review - PubMed
4 hours ago
- #minimally invasive treatments
- #urology
- #benign prostatic hyperplasia
- Minimally invasive surgical therapies (MISTs) offer symptom relief for benign prostatic hyperplasia (BPH).
- Five MISTs reviewed: water vapor thermal therapy (WVTT), prostatic urethral lift (PUL), prostatic artery embolization (PAE), temporary implantable nitinol device (iTIND), and Aquablation.
- WVTT and PUL provide durable symptom improvement, with 48% and 35% IPSS reduction at 5 years, respectively.
- Aquablation has a lower rate of retrograde ejaculation compared to traditional TURP.
- No new sexual dysfunction reported after WVTT or PUL.
- iTIND shows a long-term retrograde ejaculation rate of 4%.
- Most MISTs can be performed outpatient under local anesthesia.
- PAE achieves >44% volume reduction for prostates >80 cm³.
- Aquablation has strong evidence for larger prostates; WVTT and PUL are guideline-recommended for medium-sized glands.
- Future research should focus on comparative trials for optimized patient selection.