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The prevalence of benign prostatic hyperplasia (BPH) increases with age, affecting more than 50% of men above the age of 50 to varying degrees. As it enlarges, it compresses onto the urethra causing bladder outlet obstruction. This can cause a spectrum of problems ranging from irritative and obstructive lower urinary tract symptoms (LUTS) to retention of urine with obstructive uropathy. Transurethral resection of prostate (TURP) is the standard for surgical intervention, however with the advent of an ageing population, there is an increasing number of patients who have ischaemic heart disease who require long-term anticoagulation and have multiple co-morbidities that put them at an increased risk of general anaesthesia. This review aims to critically appraise the effectiveness and evidence for use of these minimally invasive techniques.Both PubMed and Ovid were used to search for randomised control trials (RCT) comparing the various minimally invasive techniques against TURP. In cases where there were no RCTs, the results of the respective trial were compiled. This was later compiled in a summary table.An effective minimally invasive treatment modality will play a complimentary role to TURP which remains the standard of surgical treatment for BPH. Technologies progressing towards rapid re-creation of prostatic channel, minimal blood loss and non-urethral instrumentation will bridge the divide between pharmacotherapy and surgery.

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INTRODUCTION AND OBJECTIVES: A thermo-sensitive antiadhesive with a property of sol-gel transition was manufactured by a physical mixture of Poloxamer, Chitosan and Gelatin. Poloxamerbased thermo-sensitive sol-gel has been developed to reduce the incidence of postoperative adhesion formation. The purpose of this study was to evaluate the effect of poloxamer-based thermo-sensitive sol-gel instillation after transurethral resection of the prostate (TURP) on preventing urethral stricture.METHODS: A total of 198 patients underwent TURP for benign prostatic hyperplasia.Recruited patients were randomly divided into two groups: Groups A and B. Patients in group A (100 patients, experimental group) received poloxamer-based thermo-sensitive sol-gel instillation, and patients in the group B (98 patients, control group) received lubricant instillation after TURP. Each patient was evaluated at 4 weeks (V1), 12 weeks (V2), and 24 weeks (V3) after the surgery. The effectiveness of poloxamer-based thermo-sensitive sol-gel instillation was evaluated based on the International Prostate Symptom Score (IPSS)/Quality of Life (QoL), Overactive bladder questionnaire (OAB-q), peak urine ï:‚ow rate (Qmax), voided volume, postvoid residual volume (PVR) and cystoscopy.RESULTS: Among 198 initial participants, 80 patients in group A and 83 patients in group B had completed theexperiment. There were no significant difference in IPSS/QoL, and OAB-q. However, Qmax (mL/ sec) showed significant difference between group A and group B (18.92AE9.98 vs. 15.58AE9.24, p[0.028) in 24 weeks after surgery. Also, result of PVR (mL) 24 weeks after surgery had significant difference between group A and group B (17.81AE28.33 vs. 30.12AE51.92, p[0.061). By Cystoscopy, urethral stricture after TURP was seen in 2 of 80 subjects in group A and 10 of 83 subjects in group B (p[0.023).CONCLUSIONS: Poloxamer-based thermo-sensitive sol-gel instillation after TURP decreased the incidence of urethral stricture.