Journal List > J Korean Med Assoc > v.63(2) > 1142490

Choo and Son: Current trends in minimally invasive surgery for benign prostatic hyperplasia

Abstract

The prevalence of benign prostatic hyperplasia (BPH) is rising with Korea becoming an aging society. As patients age, their comorbidities and the risks associated with anesthesia increase. Recently, there has been an increasing concern regarding sexual function after surgery. As a result, interest in minimally invasive surgery for BPH that does not require anesthesia or affect sexual function has grown. This review article introduces newly developed minimally invasive surgeries for BPH divided into four categories based on the strategy—mechanical, anatomical, atrophic, and laparoscopic. Here, the mechanisms for each surgical method have been introduced. Furthermore, recent representative studies of these procedures with a focus on randomized controlled trials and meta-analyses have also been reviewed. Side effects related to sexual function have also been mentioned briefly along with the efficacy and indication for robotic BPH surgery, which has recently been attracting attention. However, these newer, minimally invasive procedures require additional comparative randomized controlled trials and long-term results to produce more robust evidence for their use.

Figures and Tables

Table 1

Types of MIST and specific features to each type of surgery

jkma-63-119-i001

Adapted from Srinivasan A et al. World J Mens Health 2019 Aug 20 [9] and Christidis D et al. Prostate Int 2017;5:41–46 [10].

MIST, minimally invasive surgical therapies; PSA, prostate specific antigen; NA, not available.

Notes

Conflict of Interest No potential conflict of interest relevant to this article was reported.

References

1. Seo DH, Kam SC. Recent advances in laser treatment for benign prostatic hyperplasia. J Korean Med Assoc. 2017; 60:401–408.
crossref
2. Shin YS, Karna KK, Choi BR, Park JK. Finasteride and erectile dysfunction in patients with benign prostatic hyperplasia or male androgenetic alopecia. World J Mens Health. 2019; 37:157–165.
crossref pmid
3. Kim HJ. Benign prostate hyperplasia. J Korean Med Assoc. 2015; 58:878–885.
crossref
4. Park J, Cho SY, Cho MC, Jeong H, Son H. Changes in Erectile Function after Photoselective Vaporization of the Prostate with a 120-W GreenLight High-Performance System Laser: 2-Year Follow-Up. World J Mens Health. 2017; 35:156–162.
crossref pmid pmc
5. National Cancer Institute. NCI dictionary of cancer terms [Internet]. Bethesda: National Cancer Institute;2019. cited 2019 Nov 15. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/minimally-invasive-surgery.
6. Gratzke C, Bachmann A, Descazeaud A, Drake MJ, Madersbacher S, Mamoulakis C, Oelke M, Tikkinen KAO, Gravas S. EAU guidelines on the assessment of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. Eur Urol. 2015; 67:1099–1109.
crossref pmid
7. Cho MC, Song WH, Park J, Cho SY, Jeong H, Oh SJ, Paick JS, Son H. Long-Term outcomes of laser prostatectomy for storage symptoms: comparison of serial 5-year followup data between high performance system photoselective vaporization and holmium laser enucleation of the prostate. J Urol. 2018; 199:1591–1599.
crossref pmid
8. Jeon BJ, Chung H, Bae JH, Jung H, Lee JG, Choi H. Analysis of present status for surgery of benign prostatic hyperplasia in Korea using nationwide healthcare system data. Int Neurourol J. 2019; 23:22–29.
crossref pmid pmc
9. Srinivasan A, Wang R. An update on minimally invasive surgery for benign prostatic hyperplasia: techniques, risks, and efficacy. World J Mens Health. 2019; 08. 20. DOI: 10.5534/wjmh.190076. [Epub].
crossref
10. Christidis D, McGrath S, Perera M, Manning T, Bolton D, Lawrentschuk N. Minimally invasive surgical therapies for benign prostatic hypertrophy: The rise in minimally invasive surgical therapies. Prostate Int. 2017; 5:41–46.
crossref pmid pmc
11. Chin PT, Bolton DM, Jack G, Rashid P, Thavaseelan J, Yu RJ, Roehrborn CG, Woo HH. Prostatic urethral lift: two-year results after treatment for lower urinary tract symptoms secondary to benign prostatic hyperplasia. Urology. 2012; 79:5–11.
crossref pmid
12. Roehrborn CG, Barkin J, Gange SN, Shore ND, Giddens JL, Bolton DM, Cowan BE, Cantwell AL, McVary KT, Te AE, Gholami SS, Moseley WG, Chin PT, Dowling WT, Freedman SJ, Incze PF, Coffield KS, Herron S, Rashid P, Rukstalis DB. Five year results of the prospective randomized controlled prostatic urethral L.I.F.T. study. Can J Urol. 2017; 24:8802–8813.
pmid
13. Gratzke C, Barber N, Speakman MJ, Berges R, Wetterauer U, Greene D, Sievert KD, Chapple CR, Patterson JM, Fahrenkrug L, Schoenthaler M, Sonksen J. Prostatic urethral lift vs transurethral resection of the prostate: 2-year results of the BPH6 prospective, multicentre, randomized study. BJU Int. 2017; 119:767–775.
crossref pmid
14. Sonksen J, Barber NJ, Speakman MJ, Berges R, Wetterauer U, Greene D, Sievert KD, Chapple CR, Montorsi F, Patterson JM, Fahrenkrug L, Schoenthaler M, Gratzke C. Prospective, randomized, multinational study of prostatic urethral lift versus transurethral resection of the prostate: 12-month results from the BPH6 study. Eur Urol. 2015; 68:643–652.
crossref pmid
15. Perera M, Roberts MJ, Doi SA, Bolton D. Prostatic urethral lift improves urinary symptoms and flow while preserving sexual function for men with benign prostatic hyperplasia: a systematic review and meta-analysis. Eur Urol. 2015; 67:704–713.
crossref pmid
16. Armitage JN, Cathcart PJ, Rashidian A, De Nigris E, Emberton M, van der Meulen JH. Epithelializing stent for benign prostatic hyperplasia: a systematic review of the literature. J Urol. 2007; 177:1619–1624.
crossref pmid
17. Armitage JN, Rashidian A, Cathcart PJ, Emberton M, van der Meulen JH. The thermo-expandable metallic stent for managing benign prostatic hyperplasia: a systematic review. BJU Int. 2006; 98:806–810.
crossref pmid
18. Gilling P, Barber N, Bidair M, Anderson P, Sutton M, Aho T, Kramolowsky E, Thomas A, Cowan B, Kaufman RP Jr, Trainer A, Arther A, Badlani G, Plante M, Desai M, Doumanian L, Te AE, DeGuenther M, Roehrborn C. WATER: a double-blind, randomized, controlled trial of Aquablation vs transurethral resection of the prostate in benign prostatic hyperplasia. J Urol. 2018; 199:1252–1261.
crossref pmid
19. Roehrborn CG, Gange SN, Gittelman MC, Goldberg KA, Patel K, Shore ND, Levin RM, Rousseau M, Beahrs JR, Kaminetsky J, Cowan BE, Cantrill CH, Mynderse LA, Ulchaker JC, Larson TR, Dixon CM, McVary KT. Convective thermal therapy: durable 2-year results of randomized controlled and prospective crossover studies for treatment of lower urinary tract symptoms due to benign prostatic hyperplasia. J Urol. 2017; 197:1507–1516.
crossref pmid
20. Magistro G, Stief CG, Gratzke C. New intraprostatic injectables and prostatic urethral lift for male LUTS. Nat Rev Urol. 2015; 12:461–471.
crossref pmid
21. McVary KT, Roehrborn CG, Chartier-Kastler E, Efros M, Bugarin D, Chen R, Patel A, Haag-Molkenteller C. A multicenter, randomized, double-blind, placebo controlled study of onabotulinumtoxinA 200 U to treat lower urinary tract symptoms in men with benign prostatic hyperplasia. J Urol. 2014; 192:150–156.
crossref pmid
22. Shim SR, Cho YJ, Shin IS, Kim JH. Efficacy and safety of botulinum toxin injection for benign prostatic hyperplasia: a systematic review and meta-analysis. Int Urol Nephrol. 2016; 48:19–30.
crossref
23. Hwang JH, Park SW. Prostate artery embolization: treatment of symptomatic benign prostatic hyperplasia. J Korean Soc Radiol. 2019; 80:656–666.
crossref
24. Carnevale FC, Iscaife A, Yoshinaga EM, Moreira AM, Antunes AA, Srougi M. Transurethral resection of the prostate (TURP) versus original and PErFecTED prostate artery embolization (PAE) due to benign prostatic hyperplasia (BPH): preliminary results of a single center, prospective, urodynamic-controlled analysis. Cardiovasc Intervent Radiol. 2016; 39:44–52.
crossref pmid
25. Shim SR, Kanhai KJ, Ko YM, Kim JH. Efficacy and safety of prostatic arterial embolization: systematic review with meta-analysis and meta-regression. J Urol. 2017; 197:465–479.
crossref pmid
26. Li J, Cao D, Peng L, Ren Z, Gou H, Li Y, Wei Q. Comparison between minimally invasive simple prostatectomy and open simple prostatectomy for large prostates: a systematic review and meta-analysis of comparative trials. J Endourol. 2019; 33:767–776.
crossref pmid
27. Autorino R, Zargar H, Mariano MB, Sanchez-Salas R, Sotelo RJ, Chlosta PL, Castillo O, Matei DV, Celia A, Koc G, Vora A, Aron M, Parsons JK, Pini G, Jensen JC, Sutherland D, Cathelineau X, Nuñez Bragayrac LA, Varkarakis IM, Amparore D, Ferro M, Gallo G, Volpe A, Vuruskan H, Bandi G, Hwang J, Nething J, Muruve N, Chopra S, Patel ND, Derweesh I, Champ Weeks D, Spier R, Kowalczyk K, Lynch J, Harbin A, Verghese M, Samavedi S, Molina WR, Dias E, Ahallal Y, Laydner H, Cherullo E, De Cobelli O, Thiel DD, Lagerkvist M, Haber GP, Kaouk J, Kim FJ, Lima E, Patel V, White W, Mottrie A, Porpiglia F. Perioperative outcomes of robotic and laparoscopic simple prostatectomy: a European-American multi-institutional analysis. Eur Urol. 2015; 68:86–94.
crossref pmid
TOOLS
ORCID iDs

Min Soo Choo
https://orcid.org/0000-0002-7852-5822

Hwancheol Son
https://orcid.org/0000-0001-5033-0153

Similar articles