Surgical Treatment Options for High Risk Patients with Benign Prostatic Hyperplasia

Abstract

Lower urinary tract symptoms due to benign prostatic hyperplasia (BPH) are a complex symptoms that almost every man will somehow experience in some part of his life. Today, treatment of BPH can be successfully achieved in most of the cases. However, surgical therapies may become inevitable in a group of non-complient patients or in those who have failed medical therapy. The increasing incidence of systemic diseases with age may cause difficulty in decision making for surgey in high-risk patients. In this review, different treatment options such as bipolar resection, laser prostatectomy, microwave thermotherapy, ethanol ablation and radiofrequency ablation in addition to conventional transurethral resection of prostate are compared in high risk patients with BPH. Although treatment options appear to achieve comparable outcome, differences between methods are hidden in side the effects. Choosing the most appropriate method for a particular high-risk case should be based on surgeon's experience, possible side effects of the procedure and severity of comorbidities.