Open Access

REVIEW

Emerging, newly-approved treatments for lower urinary tract symptoms secondary to benign prostatic hypertrophy

Hannah Pham, Pranav Sharma

Department of Urology, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
Address correspondence to Dr. Pranav Sharma, Department of Urology, Texas Tech University Health Sciences Center, 3601 4^th Street, STOP 7260, Lubbock, TX 79430 USA

Canadian Journal of Urology 2018, 25(2), 9228-9237.

Abstract

Introduction: Oral therapy with alpha-blockers or 5-alpha reductase inhibitors remains the most common treatment for men with lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). For patients who progress or fail medical therapy, the standard of care continues to be transurethral resection of the prostate (TURP), a procedure with well-documented and durable outcomes. However, over the past decade, emerging minimally invasive options for LUS secondary to BPH have been developed, offering promising results with fewer side effects commonly associated with TURP, such as retrograde ejaculation and erectile dysfunction.
Materials and methods: A literature review was conducted using PubMed over the last 10 years with keywords including “lower urinary tract symptoms,” “benign prostatic hyperplasia,” “minimally invasive,” and “outpatient.” All relevant studies reporting on important urinary endpoints were included for each newly-approved treatment option. The available literature across varying prostate volumes was summarized.
Results: Newly approved therapies for BPH include new thermal energy sources (Rezūm, Aquablation), mechanical stenting (UroLift), prostate artery embolization, and injectable agents. These emerging techniques may be particularly suitable for patients in whom preservation of sexual function is a priority, as they demonstrate comparable urinary outcomes to medical therapy without significant sexual dysfunction. Among these, only prostate artery embolization has been extensively studied and proven efficacious in patients with prostates larger than 80 g who are not candidates for surgery.
Conclusion: We have summarized the newly approved treatment options for men with LUTS secondary to BPH as alternatives to traditional medical or surgical therapy. As more minimally invasive, office-based technologies continue to emerge, both physicians and patients will have greater flexibility to select treatments tailored to individual patient preferences and clinical needs.

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