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Lasers in benign prostatic hyperplasia
Clinical benign prostatic hyperplasia (BPH) impacts on the quality of life of many men. It is intimately related to ageing, but exact calculations of its prevalence remain difficult since an accurate clinical definition still eludes us. Histological BPH has been...Benign prostatic hyperplasia: what are the benefits and harms of various surgical management options?
Benign prostatic hyperplasia (BPH) is characterised by stromal and epithelial prostatic cell hyperplasia. The enlarged prostate may be associated with voiding and storage lower urinary tract symptoms (LUTS). These have been predominantly attributed to bladder outlet obstruction (BOO), assumed to...
The role of dutasteride in the prevention of clinical progression in asymptomatic BPH
Following the old adage ‘prevention is better than cure’, this Canadian group performed a post hoc analysis of information gained from the multicentre Reduction by Dutasteride of Prostate Cancer Events (REDUCE) study to evaluate whether dutasteride could decrease the incidence...
Convective radiofrequency water vapour thermal therapy for BPH
There are a number of new treatments for benign prostatic hyperplasia (BPH) on the market. This paper reports retrospective data for 129 patients treated with convective radiofrequency water vapour thermal therapy (Rezum) by a single surgeon. There is variable length...
PDE5I in LUTS – how do they work – no proof yet
Phosphodiesterase type 5 (PDE5) inhibitors used in erectile dysfunction (ED) have been shown to improve lower urinary tract symptoms (LUTS) as well. The mechanism is not well understood. One of the hypotheses for benign prostatic hyperplasia (BPH) – LUTS is...
NICE backs laser for BPH
Benign prostatic hyperplasia affects 60% of men aged 60 or over. The medical technology division of the National Institute for Health & Care Excellence (NICE) has supported the GreenLight XPS laser system as a surgical tool. The specific indications are:...
Prostatic artery embolisation versus sham
Randomised trials with use of sham is uncommon in the surgical literature, which makes this paper more interesting. Many different treatments are available for treating lower urinary tract symptoms / benign prostatic hyperplasia (LUTS / BPH). Prostatic artery embolisation (PAE)...
Transurethral enucleation is superior to resection for the management of LUTS secondary to BPH
This meta-analysis (Level 1b evidence) examined the efficacy and safety of two primary transurethral therapies used in the management of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH), enucleation (HoLEP – holmium laser enucleation of prostate, ThuLEP,...The medical management of LUTS/BPH – an update
For many years it has been recognised by both medical professionals and the general public that the development of lower urinary tract symptoms (LUTS) is highly prevalent and is predominantly age-dependent. Medical professionals understand that in men this is often,...
BPH therapy: how to find one’s way through the maze?
This communication is from the Young Academic Urologists (YAU) group of the European Association of Urologists (EAU). A purpose-built questionnaire of current practice was sent to 2000 members, of which 637 responded (68% were aged 50 or younger). Alpha blockers...
