Seth K. Bechis, MD, presented “Should MIST be First Line Treatment 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. “Should MIST be First Line Treatment for BPH?” January 31, 2024. Accessed Nov 2024. https://grandroundsinurology.com/should-mist-be-first-line-treatment-for-bph/
Should MIST be First Line Treatment for BPH? – Summary
Seth K. Bechis, MD, explores whether minimally invasive surgical therapies (MIST) should be the first-line treatment for BPH. He begins by highlighting the prevalence of BPH in men over 60. He acknowledges that combination therapy is extremely effective in combating BPH in the short term, but it has several long-term risks that impact patient QoL.
Dr. Bechis highlights the negative side effects of the 5-ARIs, alpha-blockers, and surgery post-medication-failure. Side effects included an increased risk of cardiac failure, dementia, depression, and sexual dysfunction.
Dr. Bechis then examines current MIST procedures for BPH treatment, including prostatic urethral lifts, water vapor thermal therapy, temporarily implanted nitinol devices, and balloons. He examines the durability, effectiveness, and side effects of each procedure and compares them to patients on medication
Dr. Bechis concludes by comparing the cost-effectiveness of MIST procedures to the cost of medication, taking into account IPSS improvement and Quality-Adjusted Life Years over time. Overall, he suggests that MIST procedures should be explored as a first-line treatment for BPH.
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 is a board-certified urologist specializing in diseases of the urinary tract, including kidney stones, benign prostatic hyperplasia (BPH) or enlarged prostate, and men's health issues. Dr. Bechis completed fellowship training in laparoscopy/robotics and endourology at the University of California (UC), San Diego School of Medicine, and residency training at Harvard Medical School, Massachusetts General Hospital in Boston. He earned his medical degree from UC San Francisco School of Medicine and holds additional Master of Science training in biomedical research, also from UC San Francisco, focusing on ways to prevent and treat diseases.
As a member of the Comprehensive Kidney Stone Center at UC San Diego Health, Dr. Bechis has a special interest in advanced surgical treatment, medical prevention, and research on kidney stone disease. He has surgical expertise in percutaneous nephrolithotomy (PCNL) for complex stones, ureteroscopy, and shockwave lithotripsy. 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 (PVP).
Dr. Bechis serves as the associate program director for the UC San Diego - Kaiser Laparoscopy/Endourology Fellowship in the Department of Urology at UC San Diego School of Medicine. His current research includes improving surgical techniques and clinical outcomes in stone disease, as well as tools for stone diagnosis and opiate-sparing pathways for managing pain. His research has been featured in peer-reviewed medical journals and he has authored chapters for university handbooks.
Prior to joining UC San Diego Health, Dr. Bechis worked at Massachusetts General Hospital and Harvard Medical School, where he taught residents and medical students in the operating room and clinic.
