The treatment of male lower urinary tract symptoms (LUTS) due to benign prostatic obstruction represents one of the major interesting aspects in urological clinical practice. Although transurethral resection of the prostate is still considered the surgical gold standard for treatment of benign prostatic hyperplasia with prostate volume <80 mL, various minimally invasive surgical treatments (MITs) have been developed to overcome the limitations of the "conventional" surgery. To date, there are no validated tools to evaluate the surgical outcomes of MITs; however, in the past, BPH-6 has been used for this purpose. In this systematic review, we evaluated the efficacy and safety of MITs according to BPH-6 score system. We focused our attention on MITs based on mechanical devices (prostatic urethral lift and the temporary implantable nitinol device) and techniques for prostate ablation (image guided robotic waterjet ablation and convective water vapor energy ablation). Evidence shows that MITs are capable of leading to an improvement in LUTS without having an overwhelming impact on complications and are a valid alternative to other treatments in patients who wish to preserve their sexual function or in case of inapplicability of conventional surgery. However, comparative studies between these techniques are still missing.
Urologia internationalis. 2021 Apr 13 [Epub ahead of print]
Francesco Cantiello, Deborah Fimognari, Marina Di Mauro, Fabio Crocerossa, Umberto Carbonara, Matteo Ferro, Ottavio De Cobelli, Giuseppe Lucarelli, Cosimo De Nunzio, Giuseppe Morgia, Rocco Damiano, Riccardo Autorino, Francesco Porpiglia, Giorgio Ivan Russo
Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy., Department of Urology, University of Catania, Catania, Italy., Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA., Department of Urology, European Institute of Oncology, Milan, Italy., Department of Urology, Andrology and Kidney Transplantation, University of Bari, Bari, Italy., Department of Urology, Sant'Andrea Hospital, Rome, Italy., Division of Urology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy.