Benign Prostatic Hyperplasia

Watch Amy E. Krambeck, MD, perform holmium laser enucleation of the prostate (HoLEP) for the treatment of lower urinary tract symptoms related to benign prostatic hyperplasia.

Benign prostatic hyperplasia (BPH) was defined as prostate size ≥ 40 g, an International Prostate Symptom Index Score ≥ 8, or using BPH medications.

"Aquablation therapy is as effective as other minimally invasive treatments [for these men] but with fewer side effects, including only a 10% to 15% risk of retrograde ejaculation," said Ravi Munver, MD.

“We’re in the process of following patients who have taken saw palmetto extract and tracking their clinical diagnosis,” says Bilal Chughtai, MD.

"It’s the most satisfying of all the things I do as a surgeon. The benefits are so dramatic and often immediate," said Daniel Kellner, MD.

Chughtai was part of an international panel of leading urologists from North America and Europe who published the consensus paper, “Rethinking the Role of Saw Palmetto Extract for Men with Lower Urinary Tract Symptoms in North America."

Minimally invasive BPH procedures relieve symptoms and can be done in outpatient settings.

"Too often, men will stay silent about the symptoms they are experiencing from an enlarged prostate that hamper their day-to-day lives," said Dean Elterman, MD.

"The ProVee System has the potential to be an effective treatment for BPH that can be safely and reliably performed in the office setting," according to Steve Kaplan, MD.

“We're doing probably one of the highest volume of HoLEP cases…in the United States,” says Nicole L. Miller, MD, FACS.

“I think that there's certainly recognition that HoLEP is a procedure that can be self-taught and learned. But I think the learning curve is significantly shortened if you're mentored and certainly if you're fellowship trained,” says Nicole L. Miller, MD, FACS.

In this installment, Howard B. Goldman, MD, FACS, discusses the development of multichannel urodynamics testing.

“What made [multichannel urodynamics] so important is you're able to diagnose things much better; you're able to have a much better understanding of what's actually going on,” says Howard B. Goldman, MD, FACS.

“For clinicians, the analyses show that moderate and severe male LUTS in general are good indicators of poor health," the authors wrote.

The study evaluated holmium laser enucleation of the prostate, open simple prostatectomy, and robotic simple prostatectomy.

It was previously reported that UroLift received reimbursement approval from the Central Social Insurance Medical Council of Japan (Chuikyo).

“Patients need to understand that even if you tell them that you may be doing this as an ambulatory procedure, they may actually have to stay afterwards, depending on what you find in the operating room or what happens in the postoperative period,” says Michael A. Palese, MD.

"Although it might be easier to enumerate the cancer conditions, in the benign world, struggles continue to overcome patients challenged with these conditions," writes Gopal H. Badlani, MD.

"We shouldn't outright provide a negative attitude to our patients who are looking for alternatives that [serve as] complementary medicine, [like] herbal or phytotherapeutic agents," says J. Curtis Nickel, MD, FRCSC.

"Overall, these findings tell us that not everyone can undergo a same-day surgery for BPH," says Michael A. Palese, MD.

5-year results from the pivotal WATER trial showed IPSS improvement was greater with Aquablation compared with TURP.

“There's no question that many patients [undergoing transurethral BPH surgery] can be done as a same-day ambulatory procedure. But you need to look at the criteria as to who you're going to keep and who you're not going to keep,” says Michael A. Palese, MD.

“I think it's important for urologists and physicians to have an open mind in regard to complementary approaches to the treatment of BPH-related LUTS in men,” says J. Curtis Nickel, MD, FRCSC.

“Even though there [are] many therapies that one can do, it's not a sign of anything ominous for most men,” says Kevin T. McVary, MD, FACS.

“The overall evidence in the global world literature is that saw palmetto can be effective,” says J. Curtis Nickel, MD, FRCSC.