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Review
. 2020 Nov;60(Suppl 1):54-62.
doi: 10.1007/s00117-020-00706-1.

Interventional therapy in benign conditions of the prostate

Attila Kovács  1
Affiliations
Review

Interventional therapy in benign conditions of the prostate

Attila Kovács. Radiologe. 2020 Nov.

Abstract
in English, German

Interventional therapies (IT) are increasingly popular treatment options for benign prostatic hyperplasia (BPH). IT aim to reduce morbidity and side effects related to invasive surgical procedures. To date, IT are considered experimental, though they are evolving rapidly and starting to challenge established surgical strategies. With gradually increasing evidence for the benefits of IT in BPH, several techniques are moving out of the realm of research and into everyday clinical practice. As such, IT provides encouraging mid-term functional outcomes with improved health-related quality of life (QoL), particularly in terms of better preservation of ejaculation. The distinct role IT could play as a bridge between exhausted drug-based treatment options and surgery is yet to be defined. Further studies are required before IT can be recommended as alternatives to invasive therapies. Systematic trials are needed to identify subgroups of patients who can benefit particularly from IT in comparison to other treatments, to identify features of the prostate particularly suited to a specific IT, and to analyze the durability of success for each technique.

Interventionelle Therapien (IT) sind zunehmend gefragte Behandlungsmöglichkeiten der benignen Prostatahyperplasie (BPH). IT zielen darauf ab, die Morbidität und die Nebenwirkungen invasiver chirurgischer Eingriffe zu verringern. Bis heute gelten IT als experimentell, obwohl sie sich rasch weiterentwickeln und teilweise mit den etablierten chirurgischen Strategien konkurrieren. Mit der zunehmenden Evidenz für den Nutzen der IT für die BPH haben bereits mehrere Techniken den Schritt aus der Forschung an die Schwelle der klinischen Praxis geschafft. Als solche liefern die IT mittelfristig ermutigende funktionelle Ergebnisse mit verbesserter gesundheitsbezogener Lebensqualität, v. a. einen besseren Erhalt der Ejakulationsfähigkeit. Die Rolle der IT als Brücke zwischen den ausgeschöpften Optionen medikamentöser Therapien und den operativen Verfahren muss noch definiert werden. Weitere Studien sind nötig, bevor IT als Alternative zu invasiven Therapien empfohlen werden können. Systematische Studien sind erforderlich, um Untergruppen von Patienten zu ermitteln, die im Vergleich zu anderen Behandlungsmethoden besonders von IT profitieren, um Merkmale der Prostata zu identifizieren, die für bestimmte IT besonders geeignet sind, und um die Dauerhaftigkeit des Erfolgs für die einzelnen Verfahren zu analysieren.

Keywords: Erectile dysfunction; Lower urinary tract symptoms; Prostatic Artery Embolization; Prostatic hyperplasia; Quality of life.

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