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Beyond medications: office-based procedures for benign prostatic obstruction

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Abstract

Purpose

When medications fail to satisfactorily treat bothersome lower urinary tract symptoms (LUTS) due to benign prostatic obstruction (BPO), procedural treatments are indicated. There is much interest in minimally invasive office-based treatments which can be performed under local anesthesia, allow fast recovery and have minimal morbidity. The purpose of this article is to review recent literature regarding safety and efficacy of office-based minimally invasive therapies for BPO.

Methods

A literature search using PUBMED and Medline was performed regarding minimally invasive office-based treatments for BPO, including the prostatic urethral lift (Urolift), water vapor therapy (Rezum) and stents. Literature published within the last 5 years were reviewed.

Results

The prostatic urethral lift (Urolift) is a safe and efficacious treatment for LUTS–BPO whilst also preserving sexual function. Rezum appears to be a safe and effective treatment in Phase 2 trials. Memokath prostatic stents do not appear to be a durable treatment; Allium prostatic stents warrant further investigation prior to recommendation.

Conclusions

The prostatic urethral lift (Urolift) is a safe and effective treatment for LUTS–BPO whilst preserving sexual function. Rezum also appears to be a safe and effective treatment in small RCTs comparing performance with TURP. Memokath prostatic stents do not appear to have treatment durability. Further studies would be warranted to determine whether Allium prostatic stents are safe effective treatments for LUTS–BPO.

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Fig. 1

(Images provided with permission to reproduce from Neotract Inc)

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Authors and Affiliations

  1. Bankstown-Lidcombe Hospital, Sydney, NSW, Australia

    Phuong U. Tran

  2. Department of Urology, Royal North Shore Hospital, The University of Sydney, Sydney, NSW, Australia

    Amanda S. J. Chung

  3. Department of Urology, Macquarie University Hospital, Sydney, NSW, Australia

    Amanda S. J. Chung

Authors
  1. Phuong U. Tran
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  2. Amanda S. J. Chung
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Contributions

PUT: data collection or management, data analysis, manuscript writing/editing, other—literature search. ASJC: data collection or management, data analysis, manuscript writing/editing, other—literature search.

Corresponding author

Correspondence to Amanda S. J. Chung.

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PUT has no conflicts of interest. ASJC has received an honorarium from Astellas Pharma Australia Pty Ltd for speaking at a symposium.

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Tran, P.U., Chung, A.S.J. Beyond medications: office-based procedures for benign prostatic obstruction. World J Urol 37, 1023–1027 (2019). https://doi.org/10.1007/s00345-019-02720-y

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  • DOI: https://doi.org/10.1007/s00345-019-02720-y

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