Advances in Surgical Therapies for BPH

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madman

Super Moderator

The video titled "BPH 101: Treatments & Aquablation With Brian Helfand, MD + Q&A" provides a comprehensive overview of the management and treatment options for benign prostatic hyperplasia (BPH), a common condition affecting men as they age. Dr. Brian Helfand, the speaker, is a urologist at NorthShore University Health System, and he discusses various aspects of BPH, including symptoms, causes, evaluation, and treatment options.

Key Points from the Transcript:​

  1. Understanding BPH:
    • BPH, or an enlarged prostate, leads to lower urinary tract symptoms (LUTS) such as frequent urination, urgency, nocturia, and a weak urinary stream.
    • While BPH is a common cause of these symptoms, other factors like diabetes, sleep apnea, and inflammatory diseases can also contribute.
  2. Diagnosis and Evaluation:
    • The evaluation of BPH includes symptom questionnaires like the International Prostate Symptom Score (IPSS) to assess the severity of symptoms.
    • Tests such as post-void residual measurement and flow rate analysis are used to understand the impact of BPH on urinary function.
  3. Treatment Options:
    • Medications: Alpha-blockers and 5-alpha-reductase inhibitors are common first-line treatments but have limitations like side effects and low long-term adherence.
    • Minimally Invasive Procedures: Techniques like UroLift and Rezum offer alternatives to medication, providing symptom relief with fewer side effects but may require repeat treatments.
    • Surgical Options: Traditional surgeries like transurethral resection of the prostate (TURP) and newer options like Holmium Laser Enucleation of the Prostate (HoLEP) are more invasive but offer significant and durable symptom relief.
  4. Aquablation Therapy:
    • Aquablation is highlighted as a novel treatment that uses a high-pressure water jet to remove prostate tissue. It is effective for any size or shape of the prostate and aims to preserve sexual function.
    • The procedure is performed under ultrasound guidance, allowing precise tissue removal and minimizing side effects like retrograde ejaculation.
  5. Research and Future Directions:
    • Ongoing research is exploring the genetic components of BPH and its association with prostate cancer.
    • Newer questionnaires and diagnostic tools are being developed to better assess and manage BPH.
  6. Patient Considerations:
    • The choice of treatment should be based on the severity of symptoms, patient preferences, and potential side effects.
    • Shared decision-making between patients and healthcare providers is crucial to selecting the most appropriate treatment option.

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