Endoscopic ablation for benign enlargement of the prostate

doi:10.1136/bmj.39582.425417.BE

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Endoscopic ablation for benign enlargement of the prostate

Newer techniques are no better than transurethral resection,but the evidence base is poor

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The prevalence of prostatic enlargement on rectal examinationreaches 50% at age 70 and directly correlates with age.¹ Theage dependent prevalence of bothersome lower urinary tract symptoms,usually attributed to prostatic enlargement, has been demonstratedin population based studies in many countries, with moderateto severe symptoms being present in 27-56% of men aged 70-79years in Scotland, France, Japan, and New Zealand.² ³ ⁴ ⁵

Transurethral resection has been the procedure of choice forsurgically treating prostatic enlargement since the 1950s. Itsuse peaked in the late 1980s and has declined with the introductionof medical treatment and alternative surgical techniques. Driversof the development of alternative surgical methods include bleeding,electrolyte abnormalities, and prolonged hospital stay associatedwith transurethral resection. The linked systematic review byLourenco and colleagues compares several alternative methodsof creating an immediate opening in the prostatic urethral channelto the gold standard—transurethral resection of the prostate.⁶. . . [Full text of this article]

Sean P Elliott, assistant professor of urological surgery

¹ University of Minnesota, MMC 394, Minneapolis, MN 55455, USA

selliott@umn.edu

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