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Current and emerging mechanical minimally invasive therapies for benign prostatic obstruction

Transurethral resection of the prostate (TURP) is considered the ‘gold standard’ for the surgical management of lower urinary tract symptoms (LUTS) due to benign prostatic obstruction (BPO). However, during recent years TURP has been challenged by several minimally invasive therapies (MITs). The rea...

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Autores principales: Sountoulides, Petros, Karatzas, Anastasios, Gravas, Stavros
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6376539/
https://www.ncbi.nlm.nih.gov/pubmed/30792821
http://dx.doi.org/10.1177/1756287219828971
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author Sountoulides, Petros
Karatzas, Anastasios
Gravas, Stavros
author_facet Sountoulides, Petros
Karatzas, Anastasios
Gravas, Stavros
author_sort Sountoulides, Petros
collection PubMed
description Transurethral resection of the prostate (TURP) is considered the ‘gold standard’ for the surgical management of lower urinary tract symptoms (LUTS) due to benign prostatic obstruction (BPO). However, during recent years TURP has been challenged by several minimally invasive therapies (MITs). The reasons for the development of these MITs are the need for anesthesia and the rather unchanged morbidity of TURP, including ejaculation disorders. Mechanical MITs may represent an attractive option for treating LUTS/BPO by using mechanical forces to maintain urethral patency without cutting, ablating, heating or removing prostatic tissue. The present paper provides an update on currently available mechanical devices for the treatment of LUTS/BPO including the prostatic urethral lift (PUL), the temporary implantable nitinol device, and new intraprostatic implants. It analyzes the evidence for their safety, tolerability, and efficacy in clinical practice and aims to define those subpopulations of patients who will benefit from these MITs. It is obvious that there is a wide variation in the degree of mature of the available mechanical MITs. Time and high-quality long-term studies will decide which of these therapies will be accepted by patients and urologists. At the moment, PUL is claiming its position in the armamentarium of BPO treatment.
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spelling pubmed-63765392019-02-21 Current and emerging mechanical minimally invasive therapies for benign prostatic obstruction Sountoulides, Petros Karatzas, Anastasios Gravas, Stavros Ther Adv Urol Review Transurethral resection of the prostate (TURP) is considered the ‘gold standard’ for the surgical management of lower urinary tract symptoms (LUTS) due to benign prostatic obstruction (BPO). However, during recent years TURP has been challenged by several minimally invasive therapies (MITs). The reasons for the development of these MITs are the need for anesthesia and the rather unchanged morbidity of TURP, including ejaculation disorders. Mechanical MITs may represent an attractive option for treating LUTS/BPO by using mechanical forces to maintain urethral patency without cutting, ablating, heating or removing prostatic tissue. The present paper provides an update on currently available mechanical devices for the treatment of LUTS/BPO including the prostatic urethral lift (PUL), the temporary implantable nitinol device, and new intraprostatic implants. It analyzes the evidence for their safety, tolerability, and efficacy in clinical practice and aims to define those subpopulations of patients who will benefit from these MITs. It is obvious that there is a wide variation in the degree of mature of the available mechanical MITs. Time and high-quality long-term studies will decide which of these therapies will be accepted by patients and urologists. At the moment, PUL is claiming its position in the armamentarium of BPO treatment. SAGE Publications 2019-02-14 /pmc/articles/PMC6376539/ /pubmed/30792821 http://dx.doi.org/10.1177/1756287219828971 Text en © The Author(s), 2019 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review
Sountoulides, Petros
Karatzas, Anastasios
Gravas, Stavros
Current and emerging mechanical minimally invasive therapies for benign prostatic obstruction
title Current and emerging mechanical minimally invasive therapies for benign prostatic obstruction
title_full Current and emerging mechanical minimally invasive therapies for benign prostatic obstruction
title_fullStr Current and emerging mechanical minimally invasive therapies for benign prostatic obstruction
title_full_unstemmed Current and emerging mechanical minimally invasive therapies for benign prostatic obstruction
title_short Current and emerging mechanical minimally invasive therapies for benign prostatic obstruction
title_sort current and emerging mechanical minimally invasive therapies for benign prostatic obstruction
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6376539/
https://www.ncbi.nlm.nih.gov/pubmed/30792821
http://dx.doi.org/10.1177/1756287219828971
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