Excerpt: The aim of this report was to compare non-drug local treatment procedures for BPS with regard to patient-relevant therapy goals. From the patient’s point of view, treatment should primarily relieve urination symptoms and improve quality of life, while at the same time cause as few adverse events as possible. For surgical procedures, it is also relevant whether hospitalisation is necessary, how long the patient has to stay in hospital, and whether or for how long he needs a urinary catheter. For this report, the treatment procedures were organised into 3 groups. The first group comprised “standard” procedures, i.e. recognised surgical procedures such as transurethral resection of the prostate (TURP) (reference method), transurethral incision of the prostate (TUIP), and removal of the prostate gland (prostatectomy), which is sometimes performed in patients with BPS who have a very large prostate. In TURP, an endoscopic probe is inserted through the urethra into the prostate. The prostatic tissue is ablated little by little with a resection loop attached to the tip of the endoscope, and is flushed out of the prostate bed and bladder. The second group comprises various newer treatment procedures that are regarded as less invasive and less burdensome for the patient. This includes holmium laser techniques, some of which use a laser probe to resect small pieces of prostate tissue, similar to the TURP method. In other laser techniques (e.g. contact laser ablation or visual laser ablation), a laser probe inserted via a cytoscope is used to heat areas of prostatic tissue to such an extent that they become necrotic. Other procedures such as microwave or ultrasound therapy also overheat prostatic tissue. The third group includes the option of initially withholding treatment (watchful waiting) and other treatment procedures such as drug therapies.
Institute for Quality and Efficiency in Health Care
Reference: Institute for Quality and Efficiency in Health Care (IQWiG); 2005-2008 Jun 02
PubMed Abstract
PMID: 23101102
