Skip to main content

Emerging Treatments in BPH

  • Chapter
  • First Online:
Male LUTS/BPH Made Easy

Abstract

Surgical treatment of BPH is well established. TURP is recognized as the gold standard procedure, and variations now exist in the form of differing energy source to complete prostate resection or enucleation. This chapter outlines newer and experimental techniques in the surgical treatment of BPH. This includes laparoscopic and robotic adenomectomy, urethral lift procedures, and intraprostatic injection of alcohol. The techniques and outcomes are described and given the paucity of long-term outcome and the lack of worldwide experience in these techniques, these techniques are considered to be in their infancy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Oelke M, Bachmann A, Descazeaud A, Emberton M, Gravas S, Michel MC, et al. Guidelines on the management of male lower urinary tract symptoms (LUTS), incl. benign prostatic obstruction (BPO): European Association of Urology. 2012; 40–70. ISBN 978-90-79754-71-7

    Google Scholar 

  2. Porpiglia F, Terrone C, Renard J, Grande S, Musso F, Cossu M, et al. Transcapsular adenomectomy(Millin): a comparative study, extraperitoneal laparoscopy versus open surgery. Eur Urol. 2006;49(1):120–6. PubMed PMID: 16310927.

    Article  PubMed  Google Scholar 

  3. Mariano MB, Graziottin TM, Tefilli MV. Laparoscopic prostatectomy with vascular control for benign prostatic hyperplasia. J Urol. 2002;167(6):2528–9. PubMed PMID: 11992078.

    Article  PubMed  Google Scholar 

  4. van Velthoven R, Peltier A, Laguna MP, Piechaud T. Laparoscopic extraperitoneal adenomectomy (Millin): pilot study on feasibility. Eur Urol. 2004;45(1):103–9; discussion 9. PubMed PMID: 14667525.

    Article  PubMed  Google Scholar 

  5. Sotelo R, Spaliviero M, Garcia-Segui A, Hasan W, Novoa J, Desai MM, et al. Laparoscopic retropubic simple prostatectomy. J Urol. 2005;173(3):757–60. PubMed PMID: 15711263.

    Article  PubMed  Google Scholar 

  6. Rey D, Ducarme G, Hoepffner JL, Staerman F. Laparoscopic adenectomy: a novel technique for managing benign prostatic hyperplasia. BJU Int. 2005;95(4):676–8. PubMed PMID: 15705103.

    Article  PubMed  Google Scholar 

  7. Asimakopoulos AD, Mugnier C, Hoepffner JL, Lopez L, Rey D, Gaston R, et al. Laparoscopic treatment of benign prostatic hyperplasia (BPH): overview of the current techniques. BJU Int. 2011;107(7):1168–82. PubMed PMID: 21438981.

    Article  PubMed  Google Scholar 

  8. Zhou LY, Xiao J, Chen H, Zhu YP, Sun YW, Xuan Q. Extraperitoneal laparoscopic adenomectomy for benign prostatic hyperplasia. World J Urol. 2009;27(3):385–7. PubMed PMID: 19082604.

    Article  PubMed  Google Scholar 

  9. Garcia Segui A, Gascon Mir M. Comparative study between laparoscopic extraperitoneal and open adenomectomy. Actas Urol Esp. 2012;36(2):110–6. PubMed PMID: WOS:000300133900009. Spanish.

    Article  PubMed  CAS  Google Scholar 

  10. Mariano MB, Tefilli MV, Graziottin TM, Morales CM, Goldraich IH. Laparoscopic prostatectomy for benign prostatic hyperplasia – a six-year experience. Eur Urol. 2006;49(1):127–31; discussion 31–2. PubMed PMID: 16314034.

    Article  PubMed  Google Scholar 

  11. Baumert H, Ballaro A, Dugardin F, Kaisary AV. Laparoscopic versus open simple prostatectomy: a comparative study. J Urol. 2006;175(5):1691–4. PubMed PMID: 16600732.

    Article  PubMed  CAS  Google Scholar 

  12. Hoepffner JL, Gaston R, Piechaud T, Rey D. Finger assisted laparoscopic retropubic prostatectomy (Millin). Eur Urol Supp. 2006;5:962–7.

    Article  Google Scholar 

  13. Chlosta PL, Varkarakis IM, Drewa T, Dobruch J, Jaskulski J, Antoniewicz AA, et al. Extraperitoneal laparoscopic Millin prostatectomy using finger enucleation. J Urol. 2011;186(3):873–6. PubMed PMID: WOS:000293688300031. English.

    Article  PubMed  Google Scholar 

  14. Rehman J, Khan SA, Sukkarieh T, Chughtai B, Waltzer WC. Extraperitoneal laparoscopic prostatectomy (adenomectomy) for obstructing benign prostatic hyperplasia: transvesical and transcapsular (Millin) techniques. J Endourol. 2005;19(4):491–6. PubMed PMID: 15910264.

    Article  PubMed  Google Scholar 

  15. Slojewski M, Golab A, Galeski M, Sikorski A. Adenomektomia laparoskopowa w leczeniu łagodnego rozrostu stercza. Urol Pol. 2008;61(11):48–54.

    Google Scholar 

  16. Porpiglia F, Fiori C, Cavallone B, Morra I, Bertolo R, Scarpa RM. Extraperitoneoscopic transcapsular adenomectomy: complications and functional results after at least 1 year of followup. J Urol. 2011;185(5):1668–73. PubMed PMID: WOS:000289279600037. English.

    Article  PubMed  Google Scholar 

  17. McCullough TC, Heldwein FL, Soon SJ, Galiano M, Barret E, Cathelineau X, et al. Laparoscopic versus open simple prostatectomy: an evaluation of morbidity. J Endourol. 2009;23(1):129–33. PubMed PMID: 19119803.

    Article  PubMed  Google Scholar 

  18. Sotelo R, Clavijo R, Carmona O, Garcia A, Banda E, Miranda M, et al. Robotic simple prostatectomy. J Urol. 2008;179(2):513–5. PubMed PMID: 18076926.

    Article  PubMed  Google Scholar 

  19. Yuh B, Laungani R, Perlmutter A, Eun D, Peabody JO, Mohler JL, et al. Robot-assisted Millin’ s retropubic prostatectomy: case series. Can J Urol. 2008;15(3):4101–5.

    PubMed  Google Scholar 

  20. Coelho RF, Chauhan S, Sivaraman A, Palmer KJ, Orvieto MA, Rocco B, et al. Modified technique of robotic-assisted simple prostatectomy: advantages of a vesico-urethral anastomosis. BJU Int. 2012;109(3):426–33. PubMed PMID: 21851543.

    Article  PubMed  Google Scholar 

  21. John H, Bucher C, Engel N, Fischer B, Fehr JL. Preperitoneal robotic prostate adenomectomy. Urology. 2009;73(4):811–5. PubMed PMID: 19195694.

    Article  PubMed  Google Scholar 

  22. Vora A, Mittal S, Hwang J, Bandi G. Robot-assisted simple prostatectomy: multi-institutional outcomes for glands larger than 100 grams. J Endourol. 2012;26(5):499–502.

    Article  PubMed  Google Scholar 

  23. Sutherland DE, Perez DS, Weeks DC. Robot-assisted simple prostatectomy for severe benign prostatic hyperplasia. J Endourol. 2011;25(4):641–4. PubMed PMID: 21413877.

    Article  PubMed  Google Scholar 

  24. Matei DV, Brescia A, Mazzoleni F, Spinelli M, Musi G, Melegari S, et al. Robot-assisted simple prostatectomy (RASP): does it make sense? BJU Int. 2012;110(11):E972–9.

    Article  PubMed  Google Scholar 

  25. Autorino R, Kaouk JH, Stolzenburg JU, Gill IS, Mottrie A, Tewari A, et al. Current status and future directions of robotic single-site surgery: a systematic review. Eur Urol. 2013;63(2):266–80. PubMed PMID: 22940173.

    Article  PubMed  Google Scholar 

  26. Desai MM, Aron M, Canes D, Fareed K, Carmona O, Haber GP, et al. Single-port transvesical simple prostatectomy: initial clinical report. Urology. 2008;72(5):960–5. PubMed PMID: 18835633.

    Article  PubMed  Google Scholar 

  27. Sotelo RJ, Astigueta JC, Desai MM, Canes D, Carmona O, De Andrade RJ, et al. Laparoendoscopic single-site surgery simple prostatectomy: initial report. Urology. 2009;74(3):626–30. PubMed PMID: 19604561.

    Article  PubMed  Google Scholar 

  28. Desai MM, Fareed K, Berger AK, Astigueta JC, Irwin BH, Aron M, et al. Single-port transvesical enucleation of the prostate: a clinical report of 34 cases. BJU Int. 2010;105(9):1296–300. PubMed PMID: 20346053.

    Article  PubMed  Google Scholar 

  29. Autorino R, Sosnowski R, De Sio M, et al. Laparo-endoscopic single-site surgery: recent advances in urology. Cent Eur J Urol. 2012;65(4):204–11.

    Article  Google Scholar 

  30. Fareed K, Zaytoun OM, Autorino R, White WM, Crouzet S, Yakoubi R, et al. Robotic single port suprapubic transvesical enucleation of the prostate (R-STEP): initial experience. BJU Int. 2012;110(5):732–7. PubMed PMID: 22340135.

    Article  PubMed  Google Scholar 

  31. Rao P, Desai M, Sotelo R, Rao P, Liu C. Hybrid LESS prostatectomy for BPH: a combined technique. Urology. 2011;78(3):64.

    Article  Google Scholar 

  32. Chin PT, Bolton DM, Jack G, Rashid P, Thavaseelan J, Yu RJ, et al. Prostatic urethral lift: two-year results after treatment for lower urinary tract symptoms secondary to benign prostatic hyperplasia. Urology. 2012;79(1):5–11. PubMed PMID: 22202539. Epub 2011/12/29. eng.

    Article  PubMed  Google Scholar 

  33. Barkin J, Giddens J, Incze P, Casey R, Richardson S, Gange S. UroLift system for relief of prostate obstruction under local anesthesia. Can J Urol. 2012;19(2):6217–22. PubMed PMID: 22512970. Epub 2012/04/20. eng.

    PubMed  Google Scholar 

  34. Grise P, Plante M, Palmer J, Martinez-Sagarra J, Hernandez C, Schettini M, et al. Evaluation of the transurethral ethanol ablation of the prostate (TEAP) for symptomatic benign prostatic hyperplasia (BPH): a European multi-center evaluation. Eur Urol. 2004;46(4):496–501; discussion 501−2. PubMed PMID: 15363567. Epub 2004/09/15. eng.

    Article  PubMed  CAS  Google Scholar 

  35. Sakr M, Eid A, Shoukry M, Fayed A. Transurethral ethanol injection therapy of benign prostatic hyperplasia: four-year follow-up. Int J Urol. 2009;16(2):196–201. PubMed PMID: 19054163. Epub 2008/12/05. eng.

    Article  PubMed  Google Scholar 

  36. El-Husseiny T, Buchholz N. Transurethral ethanol ablation of the prostate for symptomatic benign prostatic hyperplasia: long-term follow-up. J Endourol. 2011;25(3):477–80. PubMed PMID: 21355774. Epub 2011/03/02. eng.

    Article  PubMed  Google Scholar 

  37. Castillo OA, Bolufer E, López-Fontana G, Sánchez-Salas R, Fonerón A, Vidal-Mora I, et al. Prostatectomía simple (adenomectomía) por vía laparoscópica: experiencia en 59 pacientes consecutivos. Actas Urol Esp. 2011;35(7):434–7.

    Article  PubMed  CAS  Google Scholar 

  38. Barret E, Rozet F, Cathelineau X, Vallancien G. The morbidity of laparoscopic versus open simple prostatectomy. J Endourol. 2006;20(2):A271-A. PubMed PMID: WOS:000239906201342. English.

    Google Scholar 

  39. Peltier A, Hoffmann P, Hawaux E, Entezari K, Deneft F, van Velthoven R. Laparoscopic extraperitoneal Millin’ s adenomectomy versus open retropubicadenomectomy: a prospective comparison. Eur Urol Suppl. 2007;6(2):163.

    Article  Google Scholar 

  40. Uffort EE, Jensen JE. Robotic-assisted laparoscopic simple prostatectomy: an alternative minimal invasive approach for prostate adenoma. J Robot Surg. 2010;4:7–10.

    Article  Google Scholar 

  41. Matei DV, Spinelli MG, Nordio A, Brescia A, Crisan N, Coman I. Robotic simple prostatectomy. Eur Urol Supp. 2010;9(2):337.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Roman Sosnowski .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag London

About this chapter

Cite this chapter

Sosnowski, R., Thiruchelvam, N. (2014). Emerging Treatments in BPH. In: Chapple, C., Tubaro, A. (eds) Male LUTS/BPH Made Easy. Springer, London. https://doi.org/10.1007/978-1-4471-4688-9_8

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-4688-9_8

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4687-2

  • Online ISBN: 978-1-4471-4688-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics