Title Contemporary surgical treatment of benign prostate hyperplasia, advantages of different surgical methods. literature review /
Translation of Title Contemporary Surgical Treatment of Benign Prostate Hyperplasia, Advantages of Different Surgical Methods. Literature Review.
Authors Buse, Ilka Meni
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Pages 45
Keywords [eng] BPH Operation, Holmium laser enucleation, ThuVARP, Transurethral incision of prostate, Open prostatectomy for BPH, Bipolar transurethral enucleation of prostate, ThuLEP, Bipolar transurethral vaporization of the prostate, PVP prostate, Diode laser vaporization of prostate, Aquablation OR AquaBeam, PAE, Rezum Prostate, Transurethral ethanol ablation of prostate
Abstract [eng] Benign prostatic hyperplasia is a common condition among older men that leads to lower urinary tract symptoms and a reduced quality of life. This literature review compared the efficacy, safety and practical aspects of multiple minimally invasive and surgical techniques. Transurethral resection of the prostate is still a good option for patients with small prostates (<30 mL). Comparative studies of holmium laser and conventional electrocautery have shown comparable improvement in symptoms. However, holmium laser incision of the bladder neck provides better hemostasis but carries risks such as retrograde ejaculation. For patients with slightly larger prostates or when minimally invasive treatment is preferred, transurethral microwave therapy and prostatic laser focal therapy offer effective symptom reduction with fewer serious complications than transurethral resection of the prostate, although with slightly lower improvements in urinary flow rates and higher re-treatment rates. Water vapor thermal therapy (Rezūm) showed long-term effectiveness in symptom relief and improvement of quality of life. This improvement of symptoms and of maximum urinary flow was significant and its adverse events only mild and temporary. The review also analyzed other methods such as Aquablation, a robotic waterjet ablation procedure that 3 provides symptom relief comparable to transurethral resection of the prostate while having advantages in operative time, preservation of sexual function and patient recovery, making it a good choice for medium-sized prostates. The prostatic urethral lift improved urinary symptoms and quality of life. Also, it preserved ejaculatory function, which is an important factor for many patients. However, its overall symptom improvement was slightly lower than after transurethral resection of the prostate. Prostate artery embolization, vaporization and laser enucleation methods were analyzed as well. Prostate artery embolization is safer and less invasive than transurethral resection of the prostate. However, transurethral resection of the prostate has better long-term results. Laser vaporization (both diode and bipolar) led to improvements in symptoms with shorter recovery times and less blood loss. Enucleation methods, particularly holmium laser enucleation of the prostate and thulium laser enucleation of the prostate led to stable long-term results. Holmium laser enucleation of the prostate showed lower reoperation rates and thulium laser enucleation of the prostate had better hemostasis. Although this literature review concludes that transurethral resection of the prostate should still be considered the gold standard as far as symptom relief and prostate volume reduction are concerned, individual patient factors such as prostate size, concomitant disease, or desire to preserve sexual function must be considered when choosing the optimal treatment option.
Dissertation Institution Vilniaus universitetas.
Type Master thesis
Language English
Publication date 2025