Management of clinical failure after minimally invasive surgical therapies (MIST) for BPH: repeat MIST versus resection, enucleation or ablation—a narrative review from EAU endourology - Summary - MDSpire
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Management of clinical failure after minimally invasive surgical therapies (MIST) for BPH: repeat MIST versus resection, enucleation or ablation—a narrative review from EAU endourology
To determine whether failure of minimally invasive surgical therapies (MIST) for benign prostatic hyperplasia (BPH) justifies a repeat MIST or if traditional approaches like TURP or EEP are preferable, focusing on patient outcomes and clinical effectiveness.
Key Findings:
MIST techniques like PUL, iTIND, and Rezum have limited literature due to their recent adoption, which may affect their perceived efficacy.
PAE and Aquablation are better studied due to earlier introduction into clinical practice, providing a more robust evidence base.
TURP remains a common retreatment option after MIST failures due to its proven efficacy and established long-term outcomes.
Interpretation:
While MIST offers reduced invasiveness and preservation of sexual function, their long-term effectiveness compared to traditional methods remains uncertain, necessitating careful consideration in retreatment decisions, particularly in light of the limited data available.
Limitations:
Limited number of studies on newer MIST techniques may hinder understanding of their effectiveness.
Potential bias due to the small volume of literature on certain MIST methods could impact clinical decision-making.
Conclusion:
The choice between repeat MIST and traditional surgical options should be guided by individual patient circumstances, the specific MIST technique used initially, and the available evidence on outcomes.
