Transurethral prostatectomy (TURP): still the gold standard?

Area of Science:

• Urology
• Surgical Techniques
• Pharmacotherapy

Background:

• Benign Prostatic Hyperplasia (BPH) treatment requires precise indication establishment.
• Selecting appropriate procedures based on individual patient workup is essential.
• Traditional surgical interventions like TURP are well-established.

Purpose of the Study:

• To review current BPH treatment modalities and their indications.
• To compare established surgical methods with emerging minimally invasive techniques and medications.
• To emphasize the importance of accurate patient selection for optimal outcomes.

Main Methods:

• Review of current literature and clinical guidelines for BPH management.
• Discussion of established surgical procedures (TURP, open prostatectomy).
• Evaluation of minimally invasive techniques (e.g., transurethral thermotherapy) and pharmacological options (alpha-blockers, reduction inhibitors).

Main Results:

• TURP and open prostatectomy are considered the gold standard for large prostates with obstruction, offering the best long-term results.
• Minimally invasive methods are valuable for high-risk patients, aiming to reduce catheter dependency.
• New medications show promise, with ongoing research comparing their efficacy to instrumental treatments.

Conclusions:

• Accurate clinical workup for surgical indication is paramount.
• While new techniques emerge, understanding and teaching the gold standard (TURP) remains vital.
• Careful patient selection and clear indications are necessary for all BPH treatments, including novel approaches, due to potential complications.