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Minimally invasive surgical techniques must compete against pharmacotherapy in benign prostate hyperplasia (BPH)

Presented by
Prof. Damien Bolton, University of Melbourne, Australia
Conference
EAU 2019
In his Société Internationale d’Urologie (SIU) lecture “What are we aiming at? Balancing costs or optimal clinical efficacy for intervention in BPH”, Prof. Damien Bolton (University of Melbourne, Australia) said, “While TURP has and probably will remain the benchmark in terms of metrics, voiding flow, and International Prostate Symptom Score (IPSS) result, it does not tell the whole story.”

Treating BPH with drugs vs surgery has demonstrated substantial reduced costs, can be associated with less patient morbidity, and can delay definitive treatment if necessary or desired. Prof. Bolton stated that even though symptomatic improvement might be suboptimal, it is acceptable to most patients as they prioritise quality of life over their flow rate.

Prof. Bolton postulated that minimally invasive surgical techniques must compete against pharmacotherapy to demonstrate advantages and to become the established standard of care. Until robust prospective data are obtained, pharmacotherapeutic therapies need to be weighed against surgery on aspects such as time in hospital, reduced time off work, side-effect profiles, and deferred cost of definitive treatment.



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