State-of-the-art in minimally invasive treatments for benign prostatic obstruction

Area of Science:

• Urology
• Minimally Invasive Surgery
• Men's Health

Background:

• Benign prostatic obstruction (BPO), frequently caused by benign prostatic hyperplasia (BPH), significantly impacts men's quality of life.
• Traditional treatments like transurethral resection of the prostate are invasive and carry risks.
• Minimally invasive surgical therapies (MIST) have emerged as alternatives to mitigate these drawbacks.

Purpose of the Study:

• To review current evidence on established and emerging MIST for BPO.
• To evaluate the efficacy, safety, and durability of various MIST options.
• To highlight the role of MIST in personalized, function-preserving BPH management.

Main Methods:

• Narrative review of existing clinical data on MIST.
• Categorization of therapies by mechanism (thermal, mechanical, pharmacological) and application.
• Analysis of outcomes including symptom scores, urinary flow rates, quality of life, and adverse events.

Main Results:

• MIST options like Rezum, iTind, UroLift, and new stent-based therapies demonstrate efficacy in improving lower urinary tract symptoms.
• Durability ranges from one to five years, with generally mild and transient adverse events.
• Low rates of ejaculatory and erectile dysfunction are reported across most MIST interventions.

Conclusions:

• MIST provide viable, less invasive treatment options for symptomatic BPO, especially for patients unsuitable for conventional surgery.
• These therapies offer reduced recovery times and better preservation of sexual function.
• The evolving landscape of MIST supports a personalized approach to BPH management, prioritizing functional outcomes.