To scrutinize the definitions of minimal invasive surgical therapy (MIST) and to investigate urologists' knowledge, attitudes, and practices for benign prostatic obstruction surgeries.
A 36-item survey was developed with a Delphi method. Questions on definitions of MIST and attitudes and practices of benign prostatic obstruction surgeries were included. Urologists were invited globally to complete the online survey. Consensus was achieved when more than or equal to 70% responses were "agree or strongly agree" and less than or equal to 15% responses were "disagree or strongly disagree" (consensus agree), or when more than or equal to 70% responses were "disagree or strongly disagree" and less than or equal to 15% responses were "agree or strongly agree" (consensus disagree).
The top three qualities for defining MIST were minimal blood loss (n=466, 80.3%), fast post-operative recovery (n=431, 74.3%), and short hospital stay (n=425, 73.3%). The top three surgeries that were regarded as MIST were Urolift® (n=361, 62.2%), Rezum® (n=351, 60.5%), and endoscopic enucleation of the prostate (EEP) (n=332, 57.2%). Consensus in the knowledge section was achieved for the superiority of Urolift®, Rezum®, and iTIND® over transurethral resection of the prostate with regard to blood loss, recovery, day surgery feasibility, and post-operative continence. Consensus in the attitudes section was achieved for the superiority of Urolift®, Rezum®, and iTIND® over transurethral resection of the prostate with regard to blood loss, recovery, and day surgery feasibility. Consensus on both sections was achieved for EEP as the option with the better symptoms and flow improvement, lower retreatment rate, and better suitable for prostate more than 80 mL.
Minimal blood loss, fast post-operative recovery, and short hospital stay were the most important qualities for defining MIST. Urolift®, Rezum®, and EEP were regarded as MIST by most urologists.
Asian journal of urology. 2022 Aug 17 [Epub]
Bryan Kwun-Chung Cheng, Steffi Kar-Kei Yuen, Daniele Castellani, Marcelo Langer Wroclawski, Hongda Zhao, Mallikarjuna Chiruvella, Wei-Jin Chua, Ho-Yee Tiong, Yiloren Tanidir, Jean de la Rosette, Enrique Rijo, Vincent Misrai, Amy Krambeck, Dean S Elterman, Bhaskar K Somani, Jeremy Yuen-Chun Teoh, Vineet Gauhar
Department of Surgery, United Christian Hospital, Hong Kong, China., S. H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China., Department of Urology, University Hospital "Ospedali Riuniti" and Polytechnic University of Marche Region, Ancona, Italy., Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil., Department of Urology, Asian Institute of Nephrology and Urology, Hyderabad, TG, India., Department of Urology, National University Hospital, Singapore., Department of Urology, Marmara University School of Medicine, Istanbul, Turkey., Department of Urology, Medipol Mega University Hospital, Istanbul Medipol University, Istanbul, Turkey., Department of Urology, Hospital Quiron Barcelona, Barcelona, Spain., Department of Urology, Clinique Pasteur, Toulouse, France., Department of Urology, Indiana University School of Medicine, Indianapolis, IN, USA., Division of Urology, Department of Surgery, University Health Network, University of Toronto, Toronto, Canada., Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK., Department of Urology, Ng Teng Fong General Hospital, NUHS, Singapore.