Update of the minimally invasive therapies for benign prostatic hyperplasia.
OBJECTIVE
The elevated impact benign prostatic hyperplasia has on patient quality of life has determined continuous research into the development of minimally invasive therapies aimed at restoring or preserving a good quality of life. The purpose of this review is to highlight recent developments in the field of minimally invasive treatment of benign prostatic hyperplasia, and to determine their possible impact on everyday clinical practice.


RESULTS
Recent publications have described some interesting new therapies and provided data concerning long-term follow up and cost-effectiveness that have been lacking up until now. The review mainly focuses on transurethral microwave thermotherapy, interstitial laser coagulation, transurethral laser ablation, laser prostatectomies (resection and enucleation), transurethral ethanol injection therapy, transurethral electrovaporization, and high-power (80-W) potassium titanyl phosphate laser vaporization.


CONCLUSIONS
Recent developments, new approaches and long-term reports of previously described minimally invasive therapies for the treatment of benign prostatic hyperplasia are presented. Cost-effectiveness studies were also carried out to complete the comparison with standard everyday procedures. Currently, transurethral microwave thermotherapy seems to offer the soundest basis for management of the condition, providing the longest term follow up and the largest numbers of studies completed to date. Among surgical alternatives, holmium laser enucleation has gained ground as an encouraging new approach, being similar to standard transurethral resection of the prostate, but reducing perioperative morbidity with the same long-term results. More randomized comparisons correctly conducted need to be undertaken before an accurate general picture is available for the urologist.
Naspro
Richard
R
Department of Urology, University Vita-Salute-San Raffaele, San Raffaele Hospital, Milan, Italy.
Salonia
Andrea
A
Colombo
Renzo
R
Cestari
Andrea
A
Guazzoni
Giorgio
G
Rigatti
Patrizio
P
Montorsi
Francesco
F
D006801:Humans; D006979:Hyperthermia, Induced; D053685:Laser Therapy; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011468:Prostatectomy; D011470:Prostatic Hyperplasia / Q000628:therapy*; D015911:Sclerotherapy