Publication: Evaluation of new treatments for benign prostatic obstruction: ICI-RS 2023
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Date
2023-12-11
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Abstract
Aims: To address how invasive therapies for benign prostatic obstruction
(BPO) have been evaluated, what their effect is on BPO, if they can prevent
progression to BPO and how new therapies need to be evaluated before
implementation into clinical practice.
Methods: The think tank conducted a literature review and looked at the
previous and current American Urological Association, European Association
of Urology and the International Consultation on Urological Diseases
guidelines to see what procedures have been used to treat BPO. They then
assessed whether trials have been conducted before implementation of
the procedures and whether they have been compared to a “gold” standard
treatment. The use of urodynamics has also been addressed in the think tank
in relation the clinical trials as well as terminology.
Results: Guidelines vary in the use of terminology when it comes to BPO with
some continuing to use the term benign prostatic hyperplasia (BPH). There are
several procedures for example, TUNA, which have become obsolete although
continues to be mentioned in the guidelines until recently. Majority of
procedures have been introduced without comparing to “gold” standard
treatment and without any long‐term data. There continues to be many
unknowns with regard to the success of some of the BPO procedures and why
some of the adverse events develop.
Conclusion: There needs to be more robust long‐term clinical trials
conducted of new BPO therapies, with men who have both lower urinary
tract symptoms and urinary retention, before introduction into clinical
practice.
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Keywords
benign prostatic hyperplasia, benign prostatic obstruction, HoLEP, TURP, urodynamics
Citation
Hashim H., Tarcan T., Acar O., Malde S., Wein A., Abrams P., "Evaluation of new treatments for benign prostatic obstruction: ICI-RS 2023.", Neurourology and urodynamics, 2023