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Minimally invasive surgery for benign prostatic hyperplasia--a review
1Department of Surgery, National University Hospital, Singapore.
Annals of the Academy of Medicine, Singapore
|July 1, 1995
Summary
New minimally invasive therapies for benign prostatic hyperplasia (BPH) offer improved morbidity but haven't surpassed transurethral resection of the prostate (TURP) in effectiveness. Further trials are needed to establish their long-term value.
Area of Science:
- Urology
- Surgical Innovation
Background:
- Benign prostatic hyperplasia (BPH) is a common condition requiring treatment.
- Traditional treatments like open prostatectomy and transurethral resection of the prostate (TURP) are established but have limitations.
Purpose of the Study:
- To review and compare new minimally invasive therapies for BPH.
- To evaluate the effectiveness, morbidity, and cost-effectiveness of emerging BPH treatments.
Main Methods:
- Discussion of traditional BPH treatments (open prostatectomy, TURP).
- Detailed review of new minimally invasive modalities: modified TURP, non-ablative, and ablative procedures.
- Exclusion of pharmacologic treatments from the review.
Main Results:
- TURP remains the predominant treatment for obstructive BPH.
- New modalities like prostatic stents, thermotherapies (microwave, radiofrequency, focused ultrasound), and laser prostatectomy offer alternatives.
- While some new treatments show lower morbidity rates, none have surpassed TURP's effectiveness.
Conclusions:
- Emerging BPH treatments offer expanded options for urologists, with some demonstrating reduced morbidity.
- Cost and long-term efficacy remain significant considerations for these evolving therapies.
- Further rigorous, long-term randomized trials are essential to determine the optimal role of these new treatments compared to TURP.