Clinic of Urology, Medical University Sofia, Bulgaria
The urological practice has greatly changed during the last decades. There is no part of the urogenital system, which could not be reached endoscopically. That’s why today the urologists perform new, less invasive procedures, which were not applied up to now. The future of urology is to change from conventional to minimally invasive surgery. One of the most often application of these less invasive endoscopic methods is for treatment of BPH.
We present different modalities for minimally invasive treatment of BPH – TURP, types of lasers – Holmium, Thulium, KTP etc. They discuss the major concerns and needs for less invasive surgical options such as safety, efficacy and costs. Indications, advantages, disadvantages and complications of these techniques are compared, discussed and ecommended.
In conclusion we consider that:
1. Laser vaporization resection or enucleation are alternative treatment options for BPH.
2. None of these minimally invasive techniques achieved the definition of “gold standard”.
3. TUR-P is a standard procedure for small and medium prostates.
4. Open prostatectomy remains standard procedure for large prostates.
5. Aggressive marketing obscures reality.