Benign Prostatic Hyperplasia

In a recent Journal of Urology study, Jordan J. Kramer, MD, and co-authors examined whether statins impact LUTS incidence in asymptomatic men and progression in symptomatic men with BPH.

“This study was very important in that it showed cost savings with MOSES as well as the ability to reliably achieve same-day discharge,” says Matthew S. Lee, MD.

“Even factoring in the increased number of emergency room visits, there was still an overall cost savings of $747 in favor of the Moses HoLEP. So, that was surprising to see,” says Matthew S. Lee, MD.

“This study really demonstrates, for one of the first times certainly in the largest cohort of men ever [studied], that Rezum water vapor thermal therapy is a viable option to treat men with very large prostates bigger than 80 mL,” says Dean Elterman, MD, MSc, FRCSC.

“The efficiency of the procedure and clear visual opening of the prostatic urethral channel makes the Zenflow [Spring System] an exciting new tool in the treatment for BPH,” said Michael D. Trotter, MD.

“The majority of treatments out there don't allow the maintenance of ejaculation after surgery, whereas here, we're at 90% for the small glands…[and at] 81% [for] the men who had prostates above 80 grams,” says Naeem Bhojani, MD, FRCSC.

“The data is out to about 2 to 3 years now, so…[it’s] a little bit on the immature side, but it's very promising,” says Bilal Chughtai, MD.

In a recent study presented at the 2021 AUA Annual Meeting, Kevin T. McVary, MD, FACS, and co-authors assessed the 5-year outcomes of Rezum water vapor thermal therapy in patients with BPH, specifically focusing on erectile and ejaculatory function.

In a study presented at the 2021 AUA annual meeting, Bilal Chughtai, MD, and co-authors implemented the new iTind system, designed to treat patients with LUTS secondary to BPH by implanting the device via a cystoscopic procedure.

In this interview, Steven A. Kaplan, MD, discusses notable findings from a recent study evaluating multiple BPH treatments as well as his own patient selection process for treatments.

“The Zenflow device is certainly something that…appears to be able to be placed quite easily, seems to be minimally invasive [and] so far seems to be durable,” says Peter Chin, MD.

In a study presented at the 2021 AUA Annual Meeting, Andrew Higgins, MD, and co-authors implemented electrocautery protocols to mitigate blood loss among patients who undergo Aquablation.

“My patient selection process for BPH treatments can be a little bit cumbersome and take time, but that's really because for the first time ever, we have so many different options available to men,” says Dean Elterman, MD, MSc, FRCSC.

“I think Aquablation is safe. It’s efficacious, especially in these large prostates,” says Kevin Zorn, MD, FRCSC, FACS.

“For some men, it's very important to make sure that they have an antegrade ejaculation and this is a treatment modality that we're able to offer them,” says Andrew Higgins, MD.

“What's novel about the iTind system is [that] it's one of the first treatments that [can] be deployed through a flexible cystoscope, as well as the fact that there is no permanent energy or permanent foreign body that's left within the prosthetic urethra,” says Bilal Chughtai, MD.

In this interview, Dean Elterman, MD, discusses Rezum and Aquablation abstracts he presented at the 2021 AUA Annual Meeting and provides his overall perspective on the treatment of BPH.

Get ready for the 2021 AUA annual meeting with this preview of non-malignant topics.

"Patients with BPH appear to have a potential protective factor against prostate cancer," said Kiran Nandalur, MD.

The research also showed that the decision aid was well-received by patients as both satisfaction of men who used the tool and their willingness to recommend their physician were very high.

A logistic regression analysis controlling for other major comorbidities, patient age, insurance status, and type of medical therapy found that Black patients were almost 40% less likely than White patients to undergo surgery for BPH.

“Urologists tend to be early adopters of new technology. That said, how fast adoption of prostatic urethral lift has been in the urologic community was really impressive,” says Jonathan Shoag, MD.

“This study suggests that there is little difference in erectile dysfunction between the various treatments over 60-month follow-up,” says Peter Gilling, MD.

Plaintiff alleges injury occurred during insertion of Foley catheter.

“Clinicians should considerer these data when prescribing 5-ARIs to patients,” said Dr. Antonio Franco.

"Depending on the age of the surgeon, one may be surprised to hear that it was common to perform a vasectomy routinely on patients undergoing a TURP procedure," write Jonathan Rubenstein, MD, and Mark Painter.

“[These findings] provide intriguing insights into the etiology and genetic components of BPH,” said study author Joel T. Funk, MD.

A recently published study showed an increased risk of cardiac failure in men with BPH and exposure to 5-alpha reductase inhibitors and/or α-blockers.

MRI-guided transurethral ultrasound ablation (TULSA) demonstrated efficacy and safety as a treatment for patients with lower urinary tract symptoms due to benign prostatic hyperplasia.

The UroLift System is a noninvasive treatment for patients with BPH that relieves prostate obstruction by lifting and holding the prostate tissue that is blocking the urethra.