Modern advancements in minimally invasive surgical treatments for benign prostatic obstruction

Abstract

A wide variety of minimally invasive surgical techniques are now being offered for treating voiding lower urinary tract symptoms (LUTS) secondary to benign prostatic obstruction (BPO). These options offer an alternative to both medical therapy and traditional surgical options. Minimally invasive surgical treatments in LUTS/BPO boast both day case and local anaesthetic options, with a potentially reduced side effect profile compared to traditional surgical interventions matching the needs for a range of patients. We provide a narrative review of minimally invasive surgical treatments available for BPO in terms of the technology, efficacy, safety, institutional recommendations, cost and potential future developments.

Comprehensive Review on Current Controversies and Debate in Prostate Artery Embolization

“…Although radiation dose during a standard PAE procedure does not reach the levels of deterministic harm (around 3 Gy), 49 , 50 a consideration for any procedure involving radiation is the stochastic effects on patients (chance of malignancy related to the dose). The dose area product per PAE procedure is approximately 17 400 Gy/m 2 , which corresponds to an effective dose of approximately 47 mSv. In a patient population with an average age of 65, this is roughly equivalent to an additional lifetime cancer risk of 0.2% (baseline risk for men is 44.9%).…”

“…Despite benign prostate hyperplasia (BPH) being one of the most common and debilitating diseases affecting men, 1 viable minimally invasive alternatives to surgery have only emerged in the last few decades. 2 These alternatives are driven by recent technological advances in multiple fields and together they promise to create a wealth of options for the 30 million men suffering from BPH worldwide. 3 The aim is to widen the spectrum of patient choice and bridge the gap which previously existed between medication and surgery.…”

“… 3 The aim is to widen the spectrum of patient choice and bridge the gap which previously existed between medication and surgery. 2 …”

Awareness and compliance of urologists in the Middle East with minimally invasive surgical devices for the management of benign prostate hyperplasia

“…These MIDs include water steam injection devices (Rezūm), mechanical devices (prostatic urethral lift), prostatic tissue fractionation (Aquablation), Zenflow spring devices, and temporary implantable nitinol devices (iTINDs). [ 3 ]…”

Prostatic urethral calculus after water vapour thermal therapy of the prostate

“…1 More recently, efforts to improve side effects, especially sexual dysfunctions, have led to the introduction of minimally invasive surgical therapies (MIST) such as the prostatic urethral lift (PUL) and water vapour thermal therapy, marketed as Rez um™ in 2015 after demonstration of its acceptable side effect profile and significant subjective and objective improvements in symptomatic BPH. [2][3][4] In addition to the more commonly reported side effects of transurethral prostatectomy procedures, bladder or prostatic urethral stones have been documented in the medical literature post TURP, PVP, and HoLEP. [5][6][7] However, to our knowledge, prostatic urethral or bladder neck calculus formation after water vapour thermal therapy treatment of the prostate has never been described.…”