Benign prostatic hyperplasia: A review of current trends in surgical management

Authors

  • Abisola E. Oliyide Department of Urology, Stockport NHS Foundation Trust, Stockport, United Kingdom
  • Ijeoma N.C. Chibuzo Department of Urology, Stockport NHS Foundation Trust, Stockport, United Kingdom
  • Matthew Liew Department of Urology, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, United Kingdom
  • Andrew Sinclair Department of Urology, Stockport NHS Foundation Trust, Stockport, United Kingdom
  • Adebanji A.B. Adeyoju Department of Urology, Stockport NHS Foundation Trust, Stockport, United Kingdom

DOI:

https://doi.org/10.51496/jogm.v1.1

Keywords:

benign prostatic hyperplasia (BPH), minimally invasive surgical therapy (MIST), Prostate, lower urinary tract symptoms (LUTS), transurethral resection of prostate (TURP)

Abstract

Benign prostatic hyperplasia (BPH) is a common cause of lower urinary tract symptoms (LUTS) in men. It is a disorder that interferes with normal daily activities, thereby affecting the quality of life of the individual. Multiple modalities of treatment can be utilised. These include lifestyle advice, watchful waiting, medical therapy and surgical therapy. In terms of surgical therapy, varied patient, regional, socioeconomic and prostate characteristics, as well as technical skills, influence therapy choice. Currently, established techniques worldwide still confirm endoscopic resection using monopolar energy in pole position, while open surgery (particularly in sub-Saharan Africa) still prevails in the choice of surgeons because it is more accessible, both from a socio-economic standpoint and in the training of the surgical personnel. In this article, we will review the evolution of surgical therapy and current trends in surgical management and how this can be adapted to developing regions in terms of technological advancement and economic implications. Deliberate focus is placed on those contemporary minimally invasive surgical techniques that are emerging as providing strong and reproducible levels of efficacy.

References

Nimeh T, Magnan B, Almallah YZ. Benign Prostatic Hyperplasia: review of modern minimally invasive surgical treatments. Semin Intervent Radiol 2016; 33: 244–50. doi: 10.1055/s-0036-1586148

Negri E, Pelucchi C, Talamini R, Montella M, Gallus S, Bosetti C, et al. Family history of cancer and the risk of prostate cancer and Benign Prostatic Hyperplasia. Int J Cancer 2005; 114: 648–52. doi: 10.1002/ijc.20755

Kristal AR, Schenk JM, Song Y, Arnold KB, Neuhouser ML, Goodman PJ, et al. Serum steroid and sex hormone-binding globulin concentrations and the risk of incident Benign Prostatic Hyperplasia: results from the prostate cancer prevention trial. Am J Epidemiol 2008; 168: 1416–24. doi: 10.1093/aje/kwn272

Berry SJ, Coffey DS, Walsh PC, Ewing LL. The development of human Benign Prostatic Hyperplasia with age. J Urol 1984; 132: 474–9. doi: 10.1016/S0022-5347(17)49698-4

Dhingra N, Bhagwat D. Benign Prostatic Hyperplasia: an overview of existing treatment. Indian J Pharmacol 2011; 43: 6–12. doi: 10.4103/0253-7613.75657

Fine S, Mehra R. Anatomy of the prostate revisited: implications for prostate biopsy and zonal origins of prostate cancer. In: Magi-Galluzzi C, Przybycin C, (editors). Genitourinary Pathology. New York, NY: Springer; 2015. doi: 10.1007/978-1-4939-2044-0_1

Shelley HS. The enlarged prostate. A brief history of its treatment. J Hist Med Allied Sci 1969; 24: 452–73. doi: 10.1093/jhmas/XXIV.4.452

Paré A. The workes of that famous Chirugion Ambrose Parey. Trans. T. Johnson. London: Printed by Richard Cotes and Willi:Du-gard and only to be sold by John Clarke in English; 1634.

Fergusson W. Observations on lithotomy and certain cases of enlarged prostate. Lancet 1870; 1: 1–2. doi: 10.1016/S0140-6736(02)31269-8

Young HH. Conservative perineal prostatectomy. A presentation of new instruments and technique. JAMA 1903; 41: 999–1004. doi: 10.1001/jama.1903.92490360001001

Millin T. Retropubic prostatectomy: a new extravesical technique. Lancet 1945; 2: 693–6. doi: 10.1016/S0140-6736(45)91030-0

Beer E. Removal of neoplasms of the urinary bladder, a new method of employing high frequency (Oudin) current through a catheterizing cystoscopy. JAMA 1910; 54: 1768–9. doi: 10.1001/jama.1910.92550480001001c

Stern M. Resection of obstruction at the vesical orifice; new instruments resectotherm; resectoscope and new method. JAMA 1926; 87: 1726–30. doi: 10.1001/jama.1926.02680210032010

McCarthy JF. A new apparatus for endoscopic plastic surgery of the prostate, diathermia and excision of vesical growths. J Urol 1931; 26: 695–9. doi: 10.1016/S0022-5347(17)72812-1

Srinivasa A, Wang R. An update on minimally invasive surgery for Benign Prostatic Hyperplasia: techniques, risks, and efficacy. World J Men’s Heal [Internet] 2019 [cited 2020 Aug 31]; e1–10. Available from: https://wjmh.org/Synapse/Data/PDFData/2074WJMH/wjmh-37-e048.pdf

Roehrborn CG, Barkin J, Gange SN, Shore ND, Giddens JL, Bolton DM, et al. Five year results of the propective randomized controlled prostatic urethral L.I.F.T. study [Internet]. Can J Urol 2017 [cited 2020 Aug 31]; 24: 8802–13. Available from: https://www.canjurol.com/html/free-articles/V24I3_08_FREE_DrRoehrborn.pdf

Sountoulides P, Tsakiris P. The evolution of KTP laser vaporization of the prostate. Yonsei Med J 2008; 49: 189–99. doi: 10.3349/ymj.2008.49.2.189

Gilling PJ, Cass CB, Malcolm AR, Fraundorfer MR. Combination Holmium and Nd:YAG laser ablation of the prostate: initial clinical experience. J Endourol 1995; 9: 151–3. doi: 10.1089/end.1995.9.151

Watson G. Contact laser prostatectomy. World J Urol 1995; 13(2): 115–18. doi: 10.1007/BF00183625

Strope SA, Vetter J, Elliott S, Andriole GL, Olsen MA. Use of medical therapy and success of laser surgery and transurethral resection of the prostate for Benign Prostatic Hyperplasia. Urology 2015; 86: 1115–22. doi: 10.1016/j.urology.2015.07.019

Mariano MB, Graziottin TM, Tefilli MV. Laparoscopic prostatectom y for vascular control for Benign Prostatic Hyperplasia. J Urol 2002; 167: 2528–9. doi: 10.1016/S0022-5347(05)65025-2

Ferretti M, Phillips J. Prostatectomy for benign prostate disease: open, laparoscopic and robotic techniques. Can J Urol 2015; 22 Suppl 1: 60–66.

Mourmouris P, Keskin SM, Skolarikos A, Argun OB, Karagiannis AA, Tufek I, et al. A prospective comparative analysis of robot-assisted vs open simple prostatectomy for Benign Prostatic Hyperplasia. BJU Int 2019; 123: 313–17. doi: 10.1111/bju.14531

Autorino R, Zargar H, Mariano MB, Sanchez-Salas R, Sotelo RJ, Chlosta PL, et al. Perioperative outcomes of robotic and laparoscopic simple prostatectomy: a European-American multi-institutional analysis. Eur Urol 2015; 68: 86–94. doi: 10.1016/j.eururo.2014.11.044

Mamoulakis C, Ubbink DT, de la Rosette JJ. Bipolar versus monopolar transurethral resection of the prostate: a systematic review and meta-analysis of randomized controlled trials. Eur Urol 2009; 56: 798–809. doi: 10.1016/j.eururo.2009.06.037

Al-Rawashdah SF, Pastore AL, Salhi YA, Fuschi A, Petrozza V, Maurizi A, et al. Prospective randomized study comparing monopolar with bipolar transurethral resection of prostate in benign prostatic obstruction: 36-month outcomes. World J Urol 2017; 35: 1595–1601. doi: 10.1007/s00345-017-2023-7

Tang Y, Li J, Pu C, Bai Y, Yuan H, Wei Q, et al. Bipolar transurethral resection versus monopolar transurethral resection for benign prostatic hypertrophy: a systematic review and meta-analysis. J Endourol 2014; 28: 1107–14. doi: 10.1089/end.2014.0188

Okeke LI. Experience with caudal block regional anesthesia for transurethral resection of the prostate gland. West Afr J Med 2002; 21: 280–1. doi: 10.4314/wajm.v 21i4.27997

Michalak J, Tzou D, Funk J. HoLEP: the gold standard for the surgical management of BPH in the 21(st) century. Am J Clin Exp Urol [Internet] 2015 [cited 2020 Sep 1]; 3: 36–42. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26069886

Gilling PJ, Wilson LC, King CJ, Westenberg AM, Frampton CM, Fraundorfer MR. Long-term results of a randomized trial comparing holmium laser enucleation of the prostate and transurethral resection of the prostate: results at 7 years. BJU Int [Internet] 2012 [cited 2020 Sep 1]; 109: 408–11. doi 10.1111/j.1464-410X.2011.10359.x

Naspro R, Suardi N, Salonia A, Scattoni V, Guazzoni G, Colombo R, et al. Holmium laser enucleation of the prostate versus open prostatectomy for prostates >70 g: 24-month follow-up. Eur Urol 2006; 50: 563–8. doi: 10.1016/j.eururo.2006.04.003

Kuntz RM, Lehrich K, Ahyai SA. Holmium laser enucleation of the prostate versus open prostatectomy for prostates greater than 100 grams: 5-year follow-up results of a randomised clinical trial. Eur Urol 2008; 53: 160–8. doi: 10.1016/j.eururo.2007.08.036

Elshal AM, Elmansy HM, Elhilali MM. Feasibility of holmium laser enucleation of the prostate (HoLEP) for recurrent/residual Benign Prostatic Hyperplasia (BPH). BJU Int 2012; 110: E845–50. doi: 10.1111/j.1464-410X.2012.11290.x

Salonia A, Suardi N, Naspro R, Mazzoccoli B, Zanni G, Gallina A, et al. Holmium laser enucleation versus open prostatectomy for Benign Prostatic Hyperplasia: an inpatient cost analysis. Urology 2006; 68: 302–6. doi: 10.1016/j.urology.2006.02.007

Elshal AM, Mekkawy R, Laymon M, Barakat TS, Elsaadany MM, El-Assmy A, et al. Holmium laser enucleation of the prostate for treatment for large-sized benign prostate hyperplasia; is it a realistic endourologic alternative in developing country? World J Urol 2016; 34: 399–405. doi: 10.1007/s00345-015-1639-8

Varkarakis I, Kyriakakis Z, Delis A, Protogerou V, Deliveliotis C. Long-term results of open transvesical prostatectomy from a contemporary series of patients. Urology 2004; 64: 306–10. doi: 10.1016/j.urology.2004.03.033

Li M, Qiu G, Hou Q, Wang D, Huang W, Hu C, et al. Endoscopic enucleation versus open prostatectomy for treating large Benign Prostatic Hyperplasia: a meta-analysis of randomized controlled trials. PLoS One 2015; 10: e0121265. doi: 10.1371/journal.pone.0121265

Tubaro A, Carter S, Hind A, Vicentini C, Miano L. A prospective study of the safety and efficacy of suprapubic transvesical prostatectomy in patients with Benign Prostatic Hyperplasia. J Urol. 2001 Jul; 166(1): 172–6. doi: 10.1016/s0022-5347(05)66102-2

Serretta V, Morgia G, Fondacaro L, Curto G, Lo bianco A, Pirritano D, et al. Members of the Sicilian-Calabrian Society of Urology. Open prostatectomy for benign prostatic enlargement in southern Europe in the late 1990s: a contemporary series of 1800 interventions. Urology 2002; 60: 623–7. doi: 10.1016/S0090-4295(02)01860-5

Elshal AM, El-Nahas AR, Barakat TS, Elsaadany MM, El-Hefnawy AS. Transvesical open prostatectomy for Benign Prostatic Hyperplasia in the era of minimally invasive surgery: perioperative outcomes of a contemporary series. Arab J Urol 2013; 11: 362–8. doi: 10.1016/j.aju.2013.06.003

Sotelo R, Clavijo R, Carmona O, Garcia A, Banda E, Miranda M, et al. Robotic simple prostatectomy. J Urol 2008; 179: 513–15. doi: 10.1016/j.juro.2007.09.065

Lucca I, Shariat SF, Hofbauer SL, Klatte T. Outcomes of minimally invasive simple prostatectomy for Benign Prostatic Hyperplasia: a systematic review and meta-analysis. World J Urol 2015; 33: 563–70. doi: 10.1007/s00345-014-1324-3

Fischer HG, Suleman FE, Ahmad S. Outcomes of prostate artery embolisation for Benign Prostatic Hyperplasia in 10 cases at Steve Biko Academic Hospital. SA J Radiol 2019; 23: a1349. doi: 10.4102/sajr.v23i1.1349

Chitragari G, Schlosser FJ, Iyad C, Chaar O, Sumpio BE. Consequences of hypogastric artery ligation, embolization, or coverage. J Vasc Surg 2015; 62: 1340–7.e1. doi: 10.1016/j.jvs.2015.08.053

Demeritt JS, Elmasri FF, Esposito MP, Rosenberg GS. Relief of Benign Prostatic Hyperplasia-related bladder outlet obstruction after transarterial polyvinyl alcohol prostate embolization 1. J Vasc Interv Radiol 2000; 11: 767–70. doi: 10.1016/S1051-0443(07)61638-8

Hashem E, Elsobky S, Khalifa M. Prostate artery embolization for benign prostate hyperplasia review: patient selection, outcomes, and technique. Semin Ultrasound CT MRI 2020; 41: 357–65. doi: 10.1053/j.sult.2020.04.001

Russo GI, Kurbatov D, Sansalone S, Lepetukhin A, Dubsky S, Sitkin I, et al. Prostatic arterial embolization vs. open prostatectomy: a 1-year matched-pair analysis of functional outcomes and morbidities. Urology 2015; 86: 343–8. doi: 10.1016/j.urology.2015.04.037

Carnevale FC, Iscaife A, Yoshinaga EM, Moreira AM, Antunes AA, Srougi M. Transurethral Resection of the Prostate (TURP) versus original and PErFecTED Prostate Artery Embolization (PAE) due to Benign Prostatic Hyperplasia (BPH): preliminary results of a single center, prospective, urodynamic-controlled analysis. Cardiovasc Intervent Radiol 2016; 39: 44–52. doi: 10.1007/s00270-015-1202-4

Bagla S, Smirniotopoulos J, Orlando J, Piechowiak R. Cost analysis of Prostate Artery Embolization (PAE) and Transurethral Resection of the Prostate (TURP) in the treatment of Benign Prostatic Hyperplasia. Cardiovasc Intervent Radiol 2017; 40: 1694–97. doi: 10.1007/s00270-017-1700-7

Bhowmick P, Coad JE, Bhowmick S, Pryor JL, Larson T, De La Rosette J, et al. In vitro assessment of the efficacy of thermal therapy in human Benign Prostatic Hyperplasia. Int J Hyperthermia 2004; 20: 421–39. doi: 10.1080/02656730310001637343

Ramon J, Lynch TH, Eardley I, Ekman P, Frick J, Jungwirth A, et al. Transurethral needle ablation of the prostate for the treatment of Benign Prostatic Hyperplasia: a collaborative multicentre study. Br J Urol 1997; 80: 128–34. doi: 10.1046/j.1464-410X.1997.00245.x

Hill B, Belville W, Bruskewitz R, Issa M, Perez-Marrero R, Roehrborn C, et al. Transurethral needle ablation versus transurethral resection of the prostate for the treatment of symptomatic Benign Prostatic Hyperplasia: 5-year results of a prospective, randomized, multicenter clinical trial. J Urol 2004; 171: 2336–40. doi: 10.1097/01.ju.0000127761.87421.a0

Lake AM, Hall TL, Kieran K, Fowlkes JB, Cain CA, Roberts WW. Histotripsy: minimally invasive technology for prostatic tissue ablation in an in vivo canine model. Urology 2008; 72: 682–6. doi: 10.1016/j.urology.2008.01.037

Roberts WW. Development and translation of histotripsy: current status and future directions. Curr Opin Urol 2014; 24: 104–10. doi: 10.1097/MOU.0000000000000001

Madersbacher S, Schatzl G, Djavan B, Stulnig T, Marberger M. Long-term outcome of transrectal high-intensity focused ultrasound therapy for Benign Prostatic Hyperplasia. Eur Urol 2000; 37: 687–94. doi: 10.1159/000020219

NICE. Lower urinary tract symptoms in men: management [Internet]. NICE; 2010 [cited 2020 Sep 5]. Available from: https://www.nice.org.uk/guidance/cg97/chapter/1-Recommendations#alternative-and-complementary-therapies

Smith CP, Franks ME, McNeil BK, Ghosh R, De Groat WC, Chancellor MB, et al. Effect of botulinum toxin A on the autonomic nervous system of the rat lower urinary tract. J Urol 2003; 169: 1896–900. doi: 10.1097/01.ju.0000049202.56189.54

El-Dakhakhny AS, Gharib T, Issam A, El-Karamany TM. Transperineal intraprostatic injection of botulinum neurotoxin A vs. transurethral resection of prostate for management of lower urinary tract symptoms secondary to benign prostate hyperplasia: a prospective randomised study. Arab J Urol 2019; 17: 270–8. doi: 10.1080/2090598X.2019.1662214

McVary KT, Roehrborn CG, Chartier-Kastler E, Efros M, Bugarin D, Chen R, et al. A multicenter, randomized, double-blind, placebo controlled study of onabotulinumtoxina 200 U to treat lower urinary tract symptoms in men with Benign Prostatic Hyperplasia. J Urol 2014; 192: 150–6. doi: 10.1016/j.juro.2014.02.004

Doggweiler R, Zermann DH, Ishigooka M, Schmidt RA. Botox-induced prostatic involution. Prostate 1998; 31: 44–50. doi: 10.1002/(SICI)1097-0045(19980915)37:1%3C44::AID-PROS7%3E3.0.CO;2-8

Marchal C, Perez JE, Herrera B, Machuca FJ, Redondo M. The use of botulinum toxin in Benign Prostatic Hyperplasia. Neurourol Urodyn 2012; 31: 86–92. doi: 10.1002/nau.21142

NICE. 5 cost considerations: GreenLight XPS for treating Benign Prostatic Hyperplasia [Internet]. 2016 [cited 2020 Aug 31]. Available from: https://www.nice.org.uk/guidance/mtg29/chapter/5-Cost-considerations

Ajib K, Mansour M, Zanaty M, Alnazari M, Hueber PA, Meskawi M, et al. Photoselective vaporization of the prostate with the 180-W XPS-Greenlight laser: five-year experience of safety, efficiency, and functional outcomes. Can Urol Assoc J 2018; 12: E318–24. doi: 10.5489/cuaj.4895

Tuhkanen K, Antero Heino M. Contact laser prostatectomy compared to TURP in prostatic hyperplasia smaller than 40 ml: six-month follow-up with complex urodynamic assessment. Scand J Urol Nephrol 1999; 33: 31–4. doi: 10.1080/003655999750016249

Malek RS, Barrett DM, Kuntzman RS. High-power potassium-titanyl-phosphate (KTP/532) laser vaporization prostatectomy: 24 hours later. Urology 1998; 51: 254–6. doi: 10.1016/S0090-4295(97)00613-4

Gupta S. L.I.F.T. study: prostatic urethral lift for the treatment of LUTS associated with BPH. Ind J Urol [Internet]. 2014 [cited 2020 Aug 31]; 30: 235–6. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3989833/

Gratzke C, Barber N, Speakman MJ, Berges R, Wetterauer U, Greene D, et al. Prostatic urethral lift vs. transurethral resection of the prostate: 2-year results of the BPH6 prospective, multicentre, randomized study. BJU Int 2017; 119: 767–75. doi: 10.1111/bju.13714

Rukstalis D, Grier D, Stroup SP, Tutrone R, deSouza E, Freedman S, et al. Prostatic Urethral Lift (PUL) for obstructive median lobes: 12month results of the MedLift study. Prostate Cancer Prostatic Dis 2019; 22: 411–19. doi: 10.1007/s11934-013-0348-3

Larcher A, Broglia L, Lughezzani G, Mistretta F, Abrate A, Lista G, et al. Urethral lift for Benign Prostatic Hyperplasia: a comprehensive review of the literature. Curr Urol Rep 2013; 14: 620–7. doi: 10.1007/s11934-013-0348-3

Badmus TA, Asaleye CM, Badmus SA, Takure AO, Ibrahim MH, Arowolo OA. Benign prostate hyperplasia: average volume in Southwestern Nigerians and correlation with anthropometrics. Niger Postgrad Med J 2012; 19: 15–18.

Ulchaker JC, Martinson MS. Cost-effectiveness analysis of six therapies for the treatment of lower urinary tract symptoms due to Benign Prostatic Hyperplasia. Clin Outcomes Res 2018; 10: 29–43. doi: 10.2147/CEOR.S148195

NICE. Northampton general day case BPH service evaluation – adoption of Urolift [Internet]. NICE. [cited 2020 Sep 1]. Available from: https://www.nice.org.uk/sharedlearning/northampton-general-day-case-bph-service-evaluation

McVary KT, Gange SN, Gittelman MC, Goldberg KA, Patel K, Shore ND, et al. Minimally invasive prostate convective water vapor energy ablation: a multicenter, randomized, controlled study for the treatment of lower urinary tract symptoms secondary to Benign Prostatic Hyperplasia. J Urol 2016; 195: 1529–38. doi: 10.1016/j.juro.2015.10.181

McVary KT, Rogers T, Roehrborn CG. Rezūm water vapor thermal therapy for lower urinary tract symptoms associated with Benign Prostatic Hyperplasia: 4-year results from randomized controlled study. Urol Gold J 2019; 126: 171–9. doi: 10.1016/j.urology.2018.12.041

Miller LE, Chughtai B, McVary K, Gonzalez RR, Rojanasarot S, DeRouen K, et al. Water vapor thermal therapy for lower urinary tract symptoms secondary to Benign Prostatic Hyperplasia: systematic review and meta-analysis. Medicine 2020; 99: e21365. doi: 10.1097/MD.0000000000021365

Taktak S, Jones P, Haq A, Rai BP, Somani BK. Aquablation: a novel and minimally invasive surgery for benign prostate enlargement. Ther Adv Urology 2018; 10: 183–8. doi: 10.1177/1756287218760518

NICE. Interventional procedure overview (IPG1569): transurethral water jet ablation for lower urinary tract symptoms caused by Benign Prostatic Hyperplasia [Internet]. 2018 [ cited 2020 Sep 5]. Available from: https://www.nice.org.uk/guidance/ipg629/evidence/overview-final-pdf-6539031469

Gilling P, Barber N, Bidair M, Anderson P, Sutton M, Aho T, et al. WATER: a double-blind, randomized, controlled trial of aquablation® vs. transurethral resection of the prostate in Benign Prostatic Hyperplasia. J Urol 2018; 199: 1252–61. doi: 10.1016/j.juro.2017.12.065

Gilling P, Reuther R, Kahokehr A, Fraundorfer M. Aquablation – image–guided robot–assisted waterjet ablation of the prostate: initial clinical experience. BJU Int 2016; 117: 923–9. doi: 10.1111/bju.13358

Coding guide: AQUABEAM® Robotic System and Aquablation® Therapy [Internet]. 2018 [cited 2020 Sep 18]. Available from: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/newtech.html

Balakrishnan D, Jones P, Somani BK. iTIND: the second-generation temporary implantable nitinol device for minimally invasive treatment of Benign Prostatic Hyperplasia. Ther Adv Urol 2020; 12: 1756287220934355. doi: 10.1177/1756287220934355

Published

26-02-2021

How to Cite

Oliyide, A. E., Chibuzo, I. N. ., Liew, M. P., Sinclair, A. M., & Adeyoju, A. A. (2021). Benign prostatic hyperplasia: A review of current trends in surgical management. Journal of Global Medicine, 1(1), e1. https://doi.org/10.51496/jogm.v1.1

Issue

Section

Review Articles

Categories