Instrumental treatments for benign prostatic obstruction

The need to treat increasing numbers of patients with symptomatic benign prostatic obstruction has led to the continuous development of various novel or modified instrumental procedures with minimal invasiveness. The aim of the following review is to provide an overview of the current research focused on the complications and morbidity of instrumental treatment options for symptomatic benign prostatic obstruction.

A systematic Medline database search, over the past 12 months of the literature with a focus on articles about surgical treatment for benign prostatic obstruction or benign prostatic hyperplasia, provided some interesting new data concerning laser prostatectomy (holmium laser enucleation of the prostate and photoselective vaporization of the prostate) and transurethral resection of the prostate using bipolar electrocautery systems available for the review.

The data of this review period confirmed a favorable safety profile of holmium laser enucleation of the prostate for treating patients with comorbidities. Photoselective vaporization of the prostate seems to be an efficient technique with a favorable safety profile. Its long-term potential, however, has to be confirmed by randomized controlled studies. Transurethral resection of the prostate using bipolar electrocautery systems appears to offer the advantages of improved hemostasis and the ability to avoid transurethral resection syndrome. More randomized comparisons, however, need to be undertaken before an accurate general picture is available.