Prostatic tissue ablation by injection: a literature review.

Area of Science:

• Urology
• Minimally Invasive Therapies

Background:

• Benign prostatic hyperplasia (BPH) affects most men aged 50-80, with many requiring treatment for lower urinary tract symptoms (LUTS).
• While transurethral resection of the prostate is standard, minimally invasive therapies are continuously evolving.
• Intraprostatic injection, used for over a century, is re-emerging as a potential treatment for BPH.

Purpose of the Study:

• To review the historical origins and evolution of intraprostatic injections for BPH.
• To explore various routes (transperineal, transrectal, transurethral) and injectants used.
• To understand the shift in indication from urinary retention to LUTS management.

Main Methods:

• A structured MEDLINE literature review was conducted from 1966 to 2003.
• Relevant articles and historical documents dating back to 1832 were included.
• Focus on systematic evaluation of transperineal and transurethral injection routes.

Main Results:

• Intraprostatic injections can cause localized prostatic necrosis and gland volume reduction.
• Varying degrees of LUTS relief are observed with different injectants.
• Anhydrous ethanol is the most studied injectable, with advantages and disadvantages for each injection route.

Conclusions:

• Intraprostatic injection for prostatic tissue ablation holds significant potential.
• Further systematic laboratory research and ongoing clinical trials are necessary.
• The technique's long history suggests enduring therapeutic value.