Transurethral resection and other minimally invasive treatment options for BPH: would we treat ourselves as we treat our patients? Results from EAU section of uro-technology (ESUT) decision-making survey among urologists

• Published in: Central European journal of urology Vol. 77; no. 2; pp. 1 - 13
• Main Authors: Colvin, Holly, Johnston, Max, Ripa, Francesco, Sinha, Mriganka Mani, Pieptropaolo, Amelia, Brewin, James, Fiori, Christian, Gozen, Ali, Somani, Bhaskar K
• Format: Journal Article
• Language: English
• Published: Warsaw Polish Urological Association 01.04.2024
• Subjects: Catheters; Consultants; Decision making; Hyperplasia; Investigations; Lasers; Polls & surveys; Prostate cancer; Statistical analysis; Urinary retention; Urogenital system; Urology; United Kingdom > UK; United States > US
• ISSN: 2080-4806; 2080-4873
• DOI: 10.5173/ceju.2023.278

Factors such as clini-cal exposure, equipment availability, patiënt characteristics and hospital setting may affect what treatment is offered and an informed patiënt choice. The aim of this study was to investigate how urologists help patients make decisions regarding BPH management and whether their practice would differ if they were the patiënt themselves. Information regarding participants' routine investigations prior to surgery were obtained in this section; for example, whether they would use urodynamics in their assessment for BPH and LUTS, or whether they would measure prostate volume or prostate-specific antigen (PSA) prior to offering a surgical procedure. Scenarios included in the survey 1 Their standard BPH Procedure 2 Prostate volume was between 30 and 80 cc 3 Prostate volume was over 80 cc 4 High post-void residual volume (150 ml) 5 Sexual function was deemed very important 6 Sexual function not deemed important 7 Patiënt had previously had a TURP 8 Patiënt had Group 1 prostate cancer on surveillance 9 Patiënt had acute urinary retention with indwell-ing catheter 10 Patiënt had chronic urinary retention with in-dwelling catheter 11 Patiënt suffers from recurrent urinary tract in-fections 12 Patiënt takes anticoagulation medication that cannot be stopped 13 Patiënt is not fit for general or spinal anaesthesia 14 Patiënt has refractory haematuria due to BPH 15 Patiënt does not have insurance and can only af-ford a single self-pay procedure 16 Patiënt is insured and not concerned about cost Treatments included as answer choices in the survey included: monopolar TURP (mTURP), bipo-lar TURP (bTURP), Holmium laser enucleation of the prostate (HoLEP), other anatomical endoscop-ic enucleation of the prostate (AEEP), Rezum water therapy (Rezum), prostatic urethral lift (PUL), prestatie artery embolisation (PAE), Greenlight laser photoselective vapourisation of the prostate (GLL PVP), Aquablation and temporarily implanted niti-nol device (iTIND).