Issues in Benign Prostatic Obstruction
23 Mar 2015
A part of Plenary Session 3 at the 30th Anniversary Congress tackled issues in Benign Prostatic Obstruction (BPO) with speakers discussing combined medical treatments, optimizing transurethral resection of the prostate (TURP) and the role of lasers and alternative minimal invasive technologies.
In his presentation “Optimizing TURP,” Aurelien Descazeaud (FR) said laser devices posed a challenge to TURP, but the latter procedure remains a gold standard.
“Regarding literature and guidelines, TURP remains the gold standard for the ‘average BPH case’,” said Descazeaud, as he noted that a key issue is how to further reduce complications to maintain the role of TURP as a frontline procedure.
He added TURP has no specific learning curve and additional costs are lower compared to laser procedures. Minimising morbidities and improving functional outcomes should be the goal of urologists, according to Descazeaud, whilst noting thebipolar technique offers significant advantages over monopolar TURP.
Meanwhile, Prof. Jean De la Rosette (FR) assessed the range of laser technologies and said HoLEPhas a better perioperative profile. “There is less hemorrhage, lower transfusion rates and the procedure provides shorter catherisation and hospital stay for the patient; and also shorter operative time.”
Regarding alternative minimal invasive techniques, Stephan Michel (DE) gave an assessment of these procedures. He said prostatic arterial embolization (PAE) and prostatic urethral lift (PUL) are both “ready to prove their value in daily and evidence-based medicine.” The same, however, cannot be said for botox and ethanol injections which he considers obsolete and hardly have any therapeutic value.
On PRX 302, which is highly targeted to prostate tissue and delivered directly to the encapsulated prostate via localized injection, Michel said the procedure shows good functional outcome with promising results being awaited.