Dr. Das on determining the appropriate BPH treatment for each patient

Opinion
Video

"The first part is how much [are patients] bothered by the symptoms?" says Akhil Das, MD, FACS.

In this video, Akhil Das, MD, FACS, discusses the shared decision-making process for patients with BPH. Das is a UCI Health urologist and a professor of urology at UCI School of Medicine.

Transcription:

What is the shared decision-making process like for patients with BPH?

The first part is how much [are patients] bothered by the symptoms? And can we control it without doing any procedures? Can we control it with medicine? But if the symptoms are worse and there are certain criteria that lead you toward a procedure-oriented therapy, then you figure out that space there. The next step is sizing. How big is the prostate? If the prostate is under 80 g, then some of these MIST procedures are available, like UroLift, Rezum, and even Aquablation. The space for HoLEP or enucleation is any size. We try to focus on offering everything to the patient. The rubric would be, what are the patient's goals? Can they get a medical procedure? Can they have anesthesia? Do they want a no-cut procedure? Do they want something that's less invasive? Do they want something more durable? Those are the things you go through. I think counseling is really important in this situation, because it's so confusing. I think it's confusing for urologists, so it's got to be confusing for patients.

This transcription was edited for clarity.

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