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. 2015;17(3):140-9.

The Role of Minimally Invasive Surgical Techniques in the Management of Large-gland Benign Prostatic Hypertrophy

Ganesh Sivarajan  1 , Michael S Borofsky  2 , Ojas Shah  1 , James E Lingeman  2 , Herbert Lepor  1
Affiliations

The Role of Minimally Invasive Surgical Techniques in the Management of Large-gland Benign Prostatic Hypertrophy

Ganesh Sivarajan et al. Rev Urol. 2015.

Abstract

Lower urinary tract symptoms (LUTS) secondary to benign prostatic hypertrophy (BPH) are among the most common medical issues for aging men. Population-based studies suggest that 13.8% of men in their 40s and more than 40% of men over age 60 have BPH. When LUTS are refractory to medical therapy and bothersome enough to warrant surgical intervention, transurethral resection of the prostate and open simple prostatectomy have been the historical reference-standard procedures for decades. Both procedures are highly effective and offer durable improvements in urinary functional outcomes. However, they also have the potential for considerable perioperative complications and morbidity. In an effort to limit surgical morbidity, a variety of minimally invasive surgical techniques to treat BPH have been introduced. Herein we present a comprehensive, evidence-based review of the efficacy and safety profile of modern minimally invasive treatments for large-gland BPH.

Keywords: Benign prostatic hypertrophy; GreenLight photovaporization; Holmium laser enucleation of the prostate (HoLEP); Lower urinary tract symptoms; Robotic simple prostatectomy.

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Figures

Figure 1
Figure 1
Example of large-gland benign prostatic hyperplasia on computed tomography scan in the axial (above) and coronal (below) planes.
Figure 2
Figure 2
Holmium laser fiber (arrow) dissecting adenoma (asterisk) from capsule (star) during holmium laser enucleation of the prostate.
Figure 3
Figure 3
Image taken during holmium laser enucleation of the prostate after apical dissection of the left lateral lobe. The freed lobe (asterisk) can be seen floating above the veromontanum (star).
Figure 4
Figure 4
Enucleated specimen during a robotic simple prostatectomy.
See this image and copyright information in PMC

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