Office-based therapies for benign prostatic hyperplasia: a review and update

INTRODUCTION: Lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) is one of the most common conditions affecting the aging man. Over the years, various treatment modalities with distinct efficacy and safety profiles have emerged in experimental and clinical use. However, only a handful have gained in popularity and stood the test of time. MATERIALS AND METHODS: We provide an update on minimally invasive treatment modalities for BPH, specifically focused on office-based procedures namely the prostatic urethral lift (UroLift) and the convective water vapor ablation therapy (Rezum). RESULTS: Both the UroLift and Rezum have demonstrated excellent efficacy and durability in relieving LUTS in the BPH patient. When compared to the gold standard TURP, these novel therapies can also be performed as an outpatient procedure under local anesthesia, which allows for decreased hospitalization, operative and catheterization times, subsequently allowing for increased cost savings. Moreover, these procedures have no discernable adverse effects on postoperative sexual function, making it a desirable treatment option for many patients. CONCLUSIONS: Both the UroLift and Rezum are minimally invasive treatment options capable of providing rapid, significant and durable relief of LUTS secondary to BPH. They demonstrate comparable efficacy to TURP with the added advantage of preserving sexual function and decreasing patient morbidity and healthcare costs.