Outpatient surgery for lower urinary tract symptoms/benign prostatic hyperplasia: truth or myth?

Worldwide, lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH) is a common medical problem for aging men. Of patients who seek help with their symptoms, almost one-third do not respond to the medical therapy. These patients need a procedure that is safe, efficient, and durable, and at the same time carries minimal risk of side-effects. Many new technologies are introduced to our medical practice with the promise of being the ideal office-based procedure. In this review, we intend to review and discuss the role of three surgical procedures in an office setting. These include thermotherapy, 532-nm laser photo-selective vaporization of prostate, and bipolar plasma vaporization of prostate.

There are a few recent thermotherapy studies regarding the outcome of thermotherapy in LUTS/BPH patients. Data regarding the use of 532-ng laser photo-selective vaporization of prostate are scant but promising. The use of bipolar plasma vaporization is not well studied in an office setting.

In a select group of patients, thermotherapy and laser prostate surgery could be safely used to treat LUTS/BPH patients. Bipolar plasma vaporization is a promising technology, but its use in an office setting has not been completely evaluated yet.