Minimally invasive and novel procedures for the treatment of benign prostatic

Benign Prostatic Hyperplasia, sometimes referred to Benign Prostatic Enlargement, is one of the most common complications and is a term that describes a prostate measurably larger than normal, which affects men beyond their middle age. The aim of this review is the assessment advances in the minimally invasive treatment in last three decades. The PubMed and Scopus databases were searched for clinical trial with the keywords of BPH and BPE, which were published from 1985 through May 2016 with relevant abstracts. This review clarifies the key points in medical management, traditional surgical treatment and also, minimally invasive treatment options in BPH. And focus on articles about surgical treatment with holmium laser holmium laser enucleation of the prostate photoselective (HoLEP), laser vaporization of the prostate (PVP) for benign prostatic hyperplasia. Blockers cause a rapid improvement in urinary flow rate and BPH-related symptoms and 5α-reductase inhibitors have been demonstrated to reduce prevalence of prostate cancer. Complication of surgical treatment, such as clot retention or bleeding occur in about 16% of patients and open prostatectomy is limited to cases with glands of volume 100 cm3. The therapeutic options for benign prostatic hyperplasia (BPH) can be divided into medicinal, surgical and minimally invasive treatments. The minimally invasive treatment of BPH is gradually accepted by more and more urologists for its advantages of less damage, good effect, quick recovery and easy acceptance by patients, which includes transurethral needle ablation of the prostate (TUNA), transurethral microwave therapy (TUMT), PVP, HOLEP and so on. Bipolar transurethral resection of the prostate (B-TURP) was associated with a lower rate of perioperative complications. Better short-term efficacy outcomes, fewer immediate complications, and a shorter hospital stay were found after holmium laser enucleation of the prostate (HoLEP) compared with M-TURP. Compared with M-TURP, Green Light photoselective vaporization of the prostate (PVP) was associated with a shorter hospital stay and fewer complications but no different short-term efficacy outcomes. This meta-analysis shows that HoLEP is associated with more favorable outcomes than M-TURP in published RCTs today, the choice of BPH treatment requires a balance in clinical needs and considerations, the preference of patients and being cost-benefit treatment as a long-term therapy.

کلیدواژه ها:

Benign prostatic ، Transurethral needle ablation of the prostate (TUNA) ، Transurethral microwave therapy (TUMT) ، Holmium laser enucleation of the prostate (HoLEP)