Minimally Invasive Surgical Therapies (MISTs) for BPH

Minimally Invasive Surgical Therapies (MISTs) represent a range of advanced surgical options designed to alleviate the discomfort and urinary issues associated with Benign Prostatic Hyperplasia (BPH), commonly known as an enlarged prostate. It also includes non-surgical treatments like Prostate Artery Embolization (PAE). Unlike Transurethral Resection of the Prostate (TURP), which involves removing a significant amount of prostate tissue, MISTs focus on reducing bladder obstruction with minimal tissue disruption. The objective is to provide substantial symptom relief while significantly reducing the risk of adverse side effects often associated with more invasive procedures.

It’s important to note that MISTs may not always achieve the same degree of urinary flow improvement as TURP, but they can still provide equivalent relief for patients.

Here’s a closer look at some common MISTs:

• Aquablation: This technique utilizes ultrasound imaging to create a detailed map of the prostate. A robotic arm then employs a high-pressure water jet to target and remove enlarged prostate tissue. Performed under general anesthesia in a hospital or surgery center, Aquablation boasts a lower risk of side effects compared to TURP, though dry ejaculation may occur. The risk of erectile dysfunction is very low.
• Prostatic Urethral Lift (PUL): PUL involves the insertion of small metal implants that lift and hold back the enlarged prostate, effectively opening the urethra. This approach avoids cutting or heating, leading to faster recovery and fewer, milder side effects. Catheter use is less frequent post-PUL, and sexual side effects are rare. However, PUL may not be suitable for very large prostates or those with specific shapes, and long-term effectiveness is still being studied.
• Water Vapor Thermal Therapy: This method uses steam to heat and destroy excess prostate tissue. A device delivers steam to targeted areas, and the procedure can be done outpatient with sedation. While generally having a better sexual side effect profile than other procedures, retrograde ejaculation and urinary irritation can still occur.
• iTind: This involves the temporary placement of a device that reshapes the prostatic urethra, relieving obstruction. The device stays in place for five to seven days, and patients often experience quick symptom relief after its removal.
• Prostate Artery Embolization (PAE): PAE takes a different approach by reducing blood supply to the prostate, causing it to shrink over time. An interventional radiologist blocks blood flow to the prostate by injecting small particles into an artery. PAE has a very low risk of sexual side effects and often improves erectile function, but it requires specialized expertise and is not widely available. The best part about PAE are that nothing goes through the penis during the procedure or the recovery!

If you have been diagnosed with enlarged prostate or BPH, contact Summit IR to learn more.