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Putting Patients Ahead by Leaving Nothing Behind: An Emerging Treatment Paradigm in Minimally Invasive Surgical Therapy for Benign Prostatic Hyperplasia

Authors McVary KT, Chughtai B, Miller LE, Bhattacharyya SK, Dornbier RA, Elterman DS

Received 29 September 2020

Accepted for publication 3 December 2020

Published 22 February 2021 Volume 2021:14 Pages 59—64


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Dr Scott Fraser

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Kevin T McVary,1 Bilal Chughtai,2 Larry E Miller,3 Samir K Bhattacharyya,4 Ryan A Dornbier,1 Dean S Elterman5

1Center for Male Health, Department of Urology, Stritch School of Medicine, Loyola University Medical Center, Maywood, IL, USA; 2Department of Urology, Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, USA; 3Department of Biostatistics, Miller Scientific, Johnson City, TN, USA; 4Health Economics & Market Access, Boston Scientific, Marlborough, MA, USA; 5Division of Urology, University Health Network, Toronto, ON, Canada

Correspondence: Kevin T McVary
Center for Male Health, Department of Urology, Stritch School of Medicine, Loyola University Medical Center, 2160 S, First Ave, Maywood, IL 60153, USA
Email [email protected]

Abstract: Lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) are highly prevalent in older men. The long-term clinical utility of lifestyle modification and oral medications for LUTS is limited. There is a great clinical need for safe, effective, and durable BPH therapies for men who unsuccessfully attempt conservative measures. Enthusiasm for transurethral resection of the prostate has declined due to surgical risk, high rates of postoperative sexual dysfunction, and the perceived invasive nature therein. Consequently, interest has grown in developing minimally invasive surgical treatments (MISTs) that are efficacious but with a more favorable risk profile in order to better align with patient preferences. This review evaluates currently available MISTs for BPH. Further, we critically examine a “Leave Nothing Behind” philosophy in MIST for BPH since implantation of permanent metallic devices may be associated with increased long-term failure rates.

Keywords: benign prostatic hyperplasia, LUTS, minimally invasive surgical treatment, MIST, Rezum, UroLift

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