Comparing surgical treatments of benign prostate hyperplasia

This study aimed to evaluate endoscopic surgery compared to open and robotic surgery in the treatment of benign prostatic hyperplasia (BPH). This study recommended that endoscopic surgery be used first-line for the treatment of BPH.

Prostate surgery is a treatment option for benign prostatic hyperplasia (BPH). This is a non-cancerous increase in the size of the prostate. This surgery can be carried out by classic methods (open surgery) or by using special tools, often called robotic surgery. Another option is endoscopic surgery. This is the surgery of the prostate using a laser (ThuVEP). Open surgery is associated with long-term side effects. It is thought that robotic surgery can help with side-effects as smaller cuts can be made during surgery. However, the use of endoscopic surgery in BPH compared to these treatments is unclear.

This study included 105 patients who had been treated using open, robotic or endoscopic surgery. 35 patients were included in each treatment group. Questionnaires were given to patients to evaluate their quality of life (QoL) after surgery. 

Endoscopic surgery was the quickest surgery. Patients also had less blood loss and a shorter time in the hospital as compared to open and robotic surgery. Patients’ satisfaction in endoscopic and robotic surgery was higher than in open surgery.

This study concluded that endoscopic surgery showed excellent outcomes for patients with large prostates. The authors recommended that endoscopic surgery be used first-line for the treatment of BPH.

This study looked back at medical records and therefore is not a high level of evidence. Larger studies are needed for more solid evidence.