Elevated PSA and Obstructive LUTS
Bilal Chughtai, MD, addresses the relationship between elevated PSA levels and obstructive LUTS.
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Topic: BPH
Office BPH: 2024 Updates and Where Are We Going?
Kevin Zorn, MD, FRCSC, FACS, explores the evolving approaches to treating benign prostatic hyperplasia (BPH).
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Benign Prostatic Hypertrophy (BPH)
Morgan McDowell, DNP, APRN, WHNP-BC, AGPCNP-BC, delivers an overview of benign prostatic hyperplasia (BPH) grounded in the AUA guidelines.
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Surgical BPH: 2024 Updates and Where Are We Going
Nicole L. Miller, MD, FACS, delivers an incisive update on the surgical management of benign prostatic hyperplasia (BPH). In this 11-minute presentation, Dr. Miller outlines the current AUA guidelines, highlighting a broad spectrum of treatments tailored to prostate size. Trends in national data reveal that transurethral resection of the prostate (TURP) remains the dominant procedure, while minimally invasive options like UroLift have gained substantial traction.
Dr. Miller discusses emerging technologies, including the OptilumeⓇ BPH System. She also reviews promising data on MRI-guided transurethral ultrasound ablation (TULSA). Advanced laser techniques, particularly holmium pulse modulation, and thulium fiber laser, are explored for their efficacy in enucleation procedures, showing advantages in operative time, hemostasis, and same-day discharge rates. Miller highlights evolving techniques like en bloc enucleation with early apical release. A brief discussion on robotic-assisted simple prostatectomy includes recent shifts toward single-port approaches.
Dr. Miller stresses the importance of aligning treatment with patient preferences and quality-of-life goals, emphasizing shared decision-making as central to optimizing outcomes in this rapidly advancing field.
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Management of Obstructive LUTS in Men with Prostate Cancer
Kevin Zorn, MD, FRCSC, FACS, explores the management of obstructive lower urinary tract symptoms (LUTS) in men with prostate cancer.
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Biopsy Updates: Do We Have Clarity?
Ronald P. Kaufman, Jr., MD, compares transrectal and transperineal prostate biopsies, highlighting infection rates and cancer detection.
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The King of Enucleations: HoLEP
Mitchell R. Humphreys, MD, MPH, delves into benign prostatic hyperplasia management and holmium laser enucleation (HoLEP).
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5-Alpha Reductase Inhibitors Increase the Risk of Aggressive Prostate Cancer: Fact or Myth
Gerald L. Andriole, Jr., MD, challenges misconceptions about 5-ARIs in urology, focusing on their role in prostate cancer.
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Morcellation and Potential HoLEP Complications
Amy E. Krambeck, MD, discusses HoLEP morcellation and its associated complications, emphasizing procedural refinements and patient safety.
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MIST Procedures and Sexual Dysfunction
Faysal A. Yafi, MD, FRCSC, discusses minimally invasive surgical procedures and their impact on sexual dysfunction.
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Optilume for BPH
Sunchin Kim, MD, offers an in-depth exploration of OptilumeⓇ, a novel therapy for benign prostatic hyperplasia (BPH).
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Morcellation and Potential HoLEP Complications
Amy E. Krambeck, MD, presents a detailed overview of morcellation and its potential complications, particularly in Holmium Laser Enucleation of the Prostate (HoLEP). In this 14-minute presentation, she explains the technical requirements for performing morcellation.
Dr. Krambeck narrates a video of the procedure’s steps. She highlights how challenging nodules can sometimes require additional laser grooves to enable effective morcellation.
Complications during morcellation are also reviewed. Intraoperative issues include capsular perforations and bladder injuries. Injury to the ureteral orifices, while rare, can occur during morcellation. Dr. Krambeck also discusses postoperative complications and their management, including bleeding, clot retention, and infections such as UTIs or epididymitis. Incontinence, mainly urge incontinence, is another common postoperative issue. However, with proper technique, HoLEP and morcellation present low complication rates and excellent patient outcomes.
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