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Opinion|Videos|September 3, 2024

Optimizing BPH Management: Evaluating MIST Options and Key Treatment Considerations

Fact checked by: Dean Elterman, MD, MSc

Dean Elterman, MD, compares minimally invasive surgical therapy (MIST) options for prostate treatment, discussing factors influencing choice, patient experience differences, and clinical and nonclinical factors such as prostate size, symptom severity, and patient preferences.

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Video content above is prompted by the following:

  • What are some of the key differences in the minimally invasive surgical therapy (MIST) options (prostatic urethral lift [PUL], water vapor thermal therapy, robotic waterjet treatment, photoselective vaporization of the prostate)?
    • Please explain factors that may lead you to choose one MIST option over another.
  • In terms of patient experience, what are some key differences in MIST options?
    • Please speak of factors such as the need for local/general anesthesia, recovery time, time to symptom relief, preservation of sexual function, durability, etc.
  • What clinical and nonclinical factors impact your treatment choice?
    • Please speak to factors such as patient prostate size and symptom severity, common comorbidities, efficacy and durability, recovery time, and possible risks or adverse events.
    • Does a PUL give you more confidence for treating a wide range of patients if the indication for prostate volume is larger (≤100 cc) compared with other options (30-80 cc)?
    • What role does patient preference play in choosing the right treatment?

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