Is the minimally invasive treatment as good as transurethral resection for benign prostatic hyperplasia?
Despite the development of new technologies, transurethral resection of the prostate (TURP) is still considered the gold standard for surgical treatment of the benign prostate hyperplasia (BPH). In general, new minimally invasive treatments have not demonstrated better outcomes than TURP in evidence based medicine trials published to date, and should be reserved for patients who prefer to avoid surgery, who are unsuitable candidates for surgery or who no longer respond favorably to medication. TUMT and TUNA appears to be more effective than medical therapy but less effective than TURP. Both treatments can be given under topical anesthesia or local prostatic or perineal block. Efficacy of transurethral vaporization appears similar to TURP, but the studies are short-term and the glands operated on are relatively small. In patients with small prostates, the transurethral incision of the prostate can also be a good option, associated with less morbidity than TURP. Bipolar resection of the prostate is similar to TURP in effectiveness, but the data are inconclusive regarding blood loss, length of catheterization and hospital stay. Long-term comparative trials are needed to determine if the minimally invasive therapies are superior to standard TURP.
Zani
Emerson Luís
EL
Division of Urology, Hospital Israelita Albert Einstein, Unicamp R. Augusta 2347, 3o andar, 01413-000 São Paulo, Brazil.
Netto
Nelson Rodrigues
NR
D004564:Electrocoagulation; D006801:Humans; D053685:Laser Therapy; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011468:Prostatectomy; D011470:Prostatic Hyperplasia / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D020728:Transurethral Resection of Prostate / Q000379:methods*