Benign Prostatic Hyperplasia: Review of Modern Minimally Invasive Surgical Treatments

Nimeh, Tony; Magnan, Brenden; Almallah, Y. Zaki

doi:10.1055/s-0036-1586148

Cited by 10 publications

(13 citation statements)

References 42 publications

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“…Permanent stents promote epithelialization, fasten onto the prostatic stroma, and can be placed in less than 15 minutes under regional anesthesia [17]. However, the disadvantages of this procedure include possible infection (making the stent hard to remove) and possible dislodging of the stent, which can lead to urinary obstruction or total incontinence.…”

Section: Intraprostatic Stentsmentioning

confidence: 99%

“…Temporary stents are non-epithelializing, prohibitive of tissue ingrowth, and are either retrievable or biodegradable [17]. They can also be placed rather quickly and are preferred in patients who cannot undergo general anesthesia.…”

Section: Intraprostatic Stentsmentioning

confidence: 99%

“…While the mechanism has not been extensively studied, in canine models, there has been marked atrophy and diffuse apoptosis of the prostate following the blocked release of acetylcholine [27,28]. This treatment has also been shown to decrease prostatic outflow obstruction by decreasing smooth muscle tone [17].…”

Section: Delivery Devicementioning

confidence: 99%

“…Prostatic artery embolization (PAE) is a procedure carried out by interventional radiology where the vessels feeding the prostate (prostatic arteries) are blocked to impede prostatic growth and decrease urinary tract symptoms. In brief, embolization is performed by first advancing a catheter through the common femoral artery to the internal iliac artery and then through the inferior vesicle artery before arriving at the prostatic artery [17]. Prior to this, a Foley catheter is inserted to serve as a reference point for surrounding structures.…”

Section: Prostatic Artery Embolizationmentioning

confidence: 99%

“…PAE is a very safe method overall that is still accompanied by certain complications. Dysuria, hematuria, hematospermia, urinary retention, and rectal bleeding with the procedure have been noted in the literature [7,17,32]. 'Post-prostatic artery embolization syndrome' is another complication which involves the mixture of small amounts of blood with urine and stool [33].…”

Section: Prostatic Artery Embolizationmentioning

confidence: 99%

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An Update on Minimally Invasive Surgery for Benign Prostatic Hyperplasia: Techniques, Risks, and Efficacy

Srinivasan

Wang

2020

World J Mens Health

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Benign prostatic hyperplasia (BPH), a common cause of lower urinary tract symptoms in the elderly male population, has conventionally treated by transurethral resection of the prostate (TURP). During recent years, newer minimally invasive therapies (MITs) have entered the playing field and challenged TURP with their convenience, lack of sexual side effects, and overall safety. The present paper provides an update on the more heavily studied and most recent MITs, analyzing their mechanism of action, tolerability, and efficacy in clinical practice. Particularly, robust clinical data have propelled UroLift and Rezuum to the forefront in the armamentarium of minimally invasive BPH treatment. Newer mechanical therapies such as the temporary implantable nitinol device, ClearRing, ZenFlow Spring, and Butterfly are appealing options as they forego cutting, ablation, heating, or removing prostatic tissue. It is obvious that there is wide variation in the degree of clinical readiness of each modality and only time and long-term, multicenter studies will decide which of these therapies are accepted by the patient and urologist.

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Section: Intraprostatic Stentsmentioning

confidence: 99%

Section: Intraprostatic Stentsmentioning

confidence: 99%

Section: Delivery Devicementioning

confidence: 99%

Section: Prostatic Artery Embolizationmentioning

confidence: 99%

Section: Prostatic Artery Embolizationmentioning

confidence: 99%

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An Update on Minimally Invasive Surgery for Benign Prostatic Hyperplasia: Techniques, Risks, and Efficacy

Srinivasan

Wang

2020

World J Mens Health

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Differential impact of paired patient‐derived BPH and normal adjacent stromal cells on benign prostatic epithelial cell growth in 3D culture

et al. 2020

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Background Benign prostatic hyperplasia (BPH) is an age‐related disease characterized by nonmalignant abnormal growth of the prostate, which is also frequently associated with lower urinary tract symptoms. The prostate with BPH exhibits enhanced growth not only in the epithelium but also in the stroma, and stromal‐epithelial interactions are thought to play an important role in BPH pathogenesis. However, our understanding of the mechanisms of stromal‐epithelial interactions in the development and progression of BPH is very limited. Methods Matched pairs of glandular BPH and normal adjacent prostate specimens were obtained from BPH patients undergoing simple prostatectomy for symptomatic BPH. Tissues were divided further into fresh specimens for culture of primary prostatic stromal cells, and specimens were embedded in paraffin for immunohistochemical analyses. Proliferation assays, immunohistochemistry, and immunoblotting were used to characterize the primary prostate stromal cells and tissue sections. Coculture of the primary stromal cells with benign human prostate epithelial cell lines BHPrE1 or BPH‐1 was performed in three‐dimensional (3D) Matrigel to determine the impact of primary stromal cells derived from BPH on epithelial proliferation. The effect of stromal‐conditioned medium (CM) on BHPrE1 and BPH‐1 cell growth was tested in 3D Matrigel as well. Results BPH stromal cells expressed less smooth muscle actin and calponin and increased vimentin, exhibiting a more fibroblast and myofibroblast phenotype compared with normal adjacent stromal cells both in culture and in corresponding paraffin sections. Epithelial spheroids formed in 3D cocultures with primary BPH stromal cells were larger than those formed in coculture with primary normal stromal cells. Furthermore, CM from BPH stromal cells stimulated epithelial cell growth while CM from normal primary stromal cells did not in 3D culture. Conclusions These findings suggest that the stromal cells in BPH tissues are different from normal adjacent stromal cells and could promote epithelial cell proliferation, potentially contributing to the development and progression of BPH.

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Transurethral bipolar plasmakinetic vapo-enucleation of the prostate: Is it safe for patients on chronic oral anticoagulants and/or platelet aggregation inhibitors?

El‐Shaer

Abou-Taleb

Kandeel

2017

Arab Journal of Urology

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ObjectivesTo assess the safety and efficacy of bipolar plasmakinetic enucleation and resection of the prostate (PKERP) for the management of benign prostatic hyperplasia (BPH) in patients on oral anticoagulant (OAC) therapy and/or platelet aggregation inhibitors (PAIs).Patients and methodsIn all, 91 patients were recruited and underwent PKERP whilst they were receiving PAIs (aspirin, 56 patients; clopidogrel, three; aspirin and clopidogrel, 11). In all, 15 patients were receiving an OAC drug perioperatively, whilst another six patients were on dual PAIs and OACs. The primary outcomes were the perioperative morbidity and mortality rates. The secondary outcomes were functional outcomes including maximum urinary flow rate (Qmax), International Prostate Symptoms Score (IPSS), and post-void residual urine volume (PVR).ResultsThe mean (SD) age of the patients was 65 (5.9) years, preoperative adenoma volume was 80.9 (30.4) mL, and the operative time was 67 (23) min. No patient developed serious perioperative cardiovascular complications. The mean (SD) duration of hospital stay was 1.79 (1) days and the postoperative catheterisation time was 1.14 (0.76) days. The mean (SD) haemoglobin drop was 0.74 (0.61) g/dL, blood transfusion rate was 2.2%, and the clot retention rate was 2.2%. The mean (SD) postoperative Qmax was 18.6 (4.37) mL/s as compared to 7.2 (3.2) mL/s preoperatively (P < 0.001), and the preoperative IPSS was reduced from 24.3 (6.1) to 5.7 (2.3) postoperatively (P < 0.05). Prostate volume measured by transrectal ultrasonography was significantly reduced from a mean (SD) of 80.9 (30.4) mL preoperatively to 29.5 (10.6) mL postoperatively (P < 0.001).ConclusionMinimally invasive PKERP may be considered as a safe and effective treatment option for managing patients with BPH receiving OAC/PAI drugs.

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Benign Prostatic Hyperplasia: Review of Modern Minimally Invasive Surgical Treatments

Cited by 10 publications

References 42 publications

An Update on Minimally Invasive Surgery for Benign Prostatic Hyperplasia: Techniques, Risks, and Efficacy

An Update on Minimally Invasive Surgery for Benign Prostatic Hyperplasia: Techniques, Risks, and Efficacy

Differential impact of paired patient‐derived BPH and normal adjacent stromal cells on benign prostatic epithelial cell growth in 3D culture

Transurethral bipolar plasmakinetic vapo-enucleation of the prostate: Is it safe for patients on chronic oral anticoagulants and/or platelet aggregation inhibitors?

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