Seth K. Bechis, MD, presented “Making Sense of BPH: Which Treatment for Which Patient – Review of Guidelines for BPH” during the 43rd Annual Ralph E. Hopkins Urology Seminar on January 31, 2024, in Jackson Hole, Wyoming.
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How to cite: Bechis, Seth K. “Making Sense of BPH: Which Treatment for Which Patient – Review of Guidelines for BPH .” January 31, 2024. Accessed Jan 2026. https://grandroundsinurology.com/making-sense-of-bph-which-treatment-for-which-patient-review-of-guidelines-for-bph/
Making Sense of BPH: Which Treatment for Which Patient – Review of Guidelines for BPH – Summary#
Seth K. Bechis, MD, reviews the 2023 American Urological Association (AUA) guidelines for benign prostatic hyperplasia (BPH) treatment. Dr. Bechis begins by enumerating the currently available procedures for BPH treatment, with less invasive approaches favoring ease of use, minimal morbidity, and minimal ejaculatory problems versus the more invasive approaches favoring definitive efficacy and durability of results.
Dr. Bechis shares the 2023 AUA guidelines on surgical management of BPH and explains considerations for treatment choice include prostate size, presence of a median lobe, and preferences regarding sexual function. He covers guidelines for:
- Prostatic Urethral Lifts
- Water Vapor Thermal Therapy
- Temporarily Implanted Prostatic Devices
- Greenlight Photoselective Vaporization of the Prostate (PVP)
- Drug-Eluting Catheters
- Holmium Laser Enucleation of the Prostate (HoLEP)
- Robotic Waterjet Treatment (Aquablation)
Dr. Bechis concludes by explaining how he counsels patients by reviewing the data together and involving them in shared decision-making. He stresses the importance of anticipating recovery pathways and post-op hurdles for each treatment.
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About The 43rd Annual Ralph E. Hopkins Urology Seminar:#
The Ralph E. Hopkins Urology Seminar is a multi-day meeting focused on training urologists in the latest in assessing, diagnosing, and treating urologic conditions in the clinical setting. Updates are provided on urologic cancers, stone disease, urologic reconstruction, female urology, infertility, sexual function, emerging surgical techniques, and general urology. The 43rd iteration of the meeting took place from January 31st to February 2nd, 2024, in Jackson Hole, Wyoming.
For further educational activities from this conference, visit our collection page.
ABOUT THE AUTHOR
Seth K. Bechis, MD, MS, is an Associate Professor of Urology at the University of California, San Diego. Dr. Bechis specializes in all procedures of the prostate, including minimally invasive procedures such as Rezum water vapor therapy and UroLift, as well as robotic surgery and GreenLight Laser photoselective vaporization of the prostate. His current research focuses on improving surgical techniques and clinical outcomes in stone disease, as well as tools for stone diagnosis and opiate-sparing pathways for managing pain.
Dr. Bechis earned his Master’s of Science in Biomedical Sciences and his medical degree from the University of California, San Francisco. He completed his residency at Harvard University in Boston, Massachusetts. Dr. Bechis then completed a fellowship in Laparoscopy/Robotics and Endourology at the University of California, San Francisco.
Dr. Bechis is a member of several professional medical organizations, including the American Urological Association (AUA), the Endourological Society, and the Western Section of the AUA. He has won numerous awards and honors over the years, including the Whitehill Award for Excellence in Clinical Teaching in 2019, Plenary Address for Best Abstract from the American Urological Association in 2015, and first place in the 2014 Max K. Willscher Resident Research Award Competition. Dr. Bechis has been invited to speak nationally and internationally at conferences on topics including benign prostatic hyperplasia and stone disease. His research has been featured in peer-reviewed medical journals, including Journal of Urology, Journal of Endourology, and World Journal of Urology. Additionally, Dr. Bechis was editor of First Aid Q&A for the USMLE Step 1, Second Edition, and has authored chapters for university handbooks.
