Skip to main content
Log in

Treating LUTS in Men with Benign Prostatic Obstruction: A Review Article

  • Review Article
  • Published:
Drugs & Aging Aims and scope Submit manuscript

Abstract

Benign prostatic obstruction (BPO) is a prevalent condition that affects men, primarily toward their old age. The condition is often accompanied by lower urinary tract symptoms (LUTS), which can significantly impair a patient’s quality of life and lead to other medical complications. Accurate diagnosis of BPO is essential for effective management of complications secondary to BPO, and treatment plans should be tailored patients, and occasionally according to surgeon experience. As such, this literature review aims to analyze the current available data on male LUTS secondary to BPO by providing a comprehensive overview of relevant studies, as well as the surgical and medical management guidelines from the Canadian Urological Association (CUA), American Urological Association (AUA), and European Association of Urology (EAU). By synthesizing the existing literature, this review purports to summarize the current body of knowledge surrounding BPO and male LUTS, and support healthcare providers in making informed decisions about the management of male LUTS secondary to BPO, ultimately improving patient outcomes and quality of life.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Ng M, Baradhi KM. Benign prostatic hyperplasia. StatPearls, Treasure Island: StatPearls Publishing; 2022.

    Google Scholar 

  2. Lerner LB, McVary KT, Barry MJ, Bixler BR, Dahm P, Das AK, et al. Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA GUIDELINE PART I-Initial work-up and medical management. J Urol. 2021;206:806–17. https://doi.org/10.1097/JU.0000000000002183.

    Article  PubMed  Google Scholar 

  3. Billet M, Windsor TA. Urinary retention. Emerg Med Clin North Am. 2019;37:649–60. https://doi.org/10.1016/j.emc.2019.07.005.

    Article  PubMed  Google Scholar 

  4. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology. 2003;61:37–49. https://doi.org/10.1016/s0090-4295(02)02243-4.

    Article  PubMed  Google Scholar 

  5. Cornu JN, Gacci M, Hashim H, Herrmann TRW, Malde S, Netsch C, et al. EAU guidelines on management of non-neurogenic male lower urinary tract symptoms (LUTS), incl. Benign Prostatic Obstruction (BPO). EAU Guidel., Arnhem, the Netherlands: EAU Guidelines Office; 2023.

  6. Elterman D, Aubé-Peterkin M, Evans H, Elmansy H, Meskawi M, Zorn KC, et al. UPDATE—Canadian Urological Association guideline: male lower urinary tract symptoms/benign prostatic hyperplasia. Can Urol Assoc J J Assoc Urol Can. 2022;16:245–56. https://doi.org/10.5489/cuaj.7906.

    Article  Google Scholar 

  7. Bouhadana D, Sadri I. An approach to the management of lower urinary tract symptoms secondary to benign prostatic hyperplasia. McGill J Med. 2022. https://doi.org/10.26443/mjm.v20i2.330.

    Article  Google Scholar 

  8. Hansen BJ, Mortensen S, Mensink HJ, Flyger H, Riehmann M, Hendolin N, et al. Comparison of the Danish Prostatic Symptom Score with the International Prostatic Symptom Score, the Madsen-Iversen and Boyarsky symptom indexes. ALFECH Study Group. Br J Urol. 1998;81:36–41. https://doi.org/10.1046/j.1464-410x.1998.00524.x.

    Article  CAS  PubMed  Google Scholar 

  9. Fujimura T, Kume H, Nishimatsu H, Sugihara T, Nomiya A, Tsurumaki Y, et al. Assessment of lower urinary tract symptoms in men by international prostate symptom score and core lower urinary tract symptom score. BJU Int. 2012;109:1512–6. https://doi.org/10.1111/j.1464-410X.2011.10445.x.

    Article  PubMed  Google Scholar 

  10. Barry MJ, Fowler FJ, O’Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK, et al. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol. 1992;148:1549–57. https://doi.org/10.1016/s0022-5347(17)36966-5. (discussion 1564).

    Article  CAS  PubMed  Google Scholar 

  11. Guzelsoy M, Erkan A, Ozturk M, Zengin S, Coban S, Turkoglu AR, et al. Comparison of three questionnaire forms used in the diagnosis of lower urinary tract symptoms: a prospective study. Prostate Int. 2022;10:218–23. https://doi.org/10.1016/j.prnil.2022.06.001.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Thompson IM, Goodman PJ, Tangen CM, Lucia MS, Miller GJ, Ford LG, et al. the influence of finasteride on the development of prostate cancer. N Engl J Med. 2003;349:215–24. https://doi.org/10.1056/NEJMoă60.

    Article  CAS  PubMed  Google Scholar 

  13. Andriole GL, Bostwick DG, Brawley OW, Gomella LG, Marberger M, Montorsi F, et al. Effect of dutasteride on the risk of prostate cancer. N Engl J Med. 2010;362:1192–202. https://doi.org/10.1056/NEJMoa0908127.

    Article  CAS  PubMed  Google Scholar 

  14. Klotz L, Chetner M, Chin J, Finelli T, Fleshner N, Fradet Y, et al. Canadian consensus conference: the FDA decision on the use of 5ARIs. Can Urol Assoc J J Assoc Urol Can. 2012;6:83–8. https://doi.org/10.5489/cuaj.12058.

    Article  Google Scholar 

  15. Lerner LB, McVary KT, Barry MJ, Bixler BR, Dahm P, Das AK, et al. Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA GUIDELINE PART II-Surgical evaluation and treatment. J Urol. 2021;206:818–26. https://doi.org/10.1097/JU.0000000000002184.

    Article  PubMed  Google Scholar 

  16. Bouhadana D, Nguyen D-D, Raizenne B, Schwarcz J, Gordon H, Chughtai B, et al. Evaluating the acceptability of an online patient decision aid for the surgical management of lower urinary tract symptoms secondary to benign prostatic hyperplasia. Can Urol Assoc J. 2021;15:247–54. https://doi.org/10.5489/cuaj.7492.

    Article  PubMed  PubMed Central  Google Scholar 

  17. BPH Outcomes Study - Educational Visualisation Tool n.d. https://www.bphtool.com/BPHTool/. Accessed 3 Mar 2023.

  18. Gravas S, Palacios-Moreno JM, Thompson D, Concas F, Kamola PJ, Roehrborn CG, et al. Understanding treatment response in individual profiles of men with prostatic enlargement at risk of progression. Eur Urol Focus. 2023;9:178–87. https://doi.org/10.1016/j.euf.2022.07.004.

    Article  PubMed  Google Scholar 

  19. Netto NR, de Lima ML, Netto MR, D’Ancona CA. Evaluation of patients with bladder outlet obstruction and mild international prostate symptom score followed up by watchful waiting. Urology. 1999;53:314–6. https://doi.org/10.1016/s0090-4295(98)00475-0.

    Article  PubMed  Google Scholar 

  20. Kirby RS. The natural history of benign prostatic hyperplasia: what have we learned in the last decade? Urology. 2000;56:3–6. https://doi.org/10.1016/s0090-4295(00)00747-0.

    Article  CAS  PubMed  Google Scholar 

  21. Ball AJ, Feneley RC, Abrams PH. The natural history of untreated “prostatism.” Br J Urol. 1981;53:613–6. https://doi.org/10.1111/j.1464-410x.1981.tb03273.x.

    Article  CAS  PubMed  Google Scholar 

  22. Kyprianou N, Litvak JP, Borkowski A, Alexander R, Jacobs SC. Induction of prostate apoptosis by doxazosin in benign prostatic hyperplasia. J Urol. 1998;159:1810–5. https://doi.org/10.1016/S0022-5347(01)63162-8.

    Article  CAS  PubMed  Google Scholar 

  23. Kyprianou N, Chon J, Benning CM. Effects of alpha(1)-adrenoceptor (alpha(1)-AR) antagonists on cell proliferation and apoptosis in the prostate: therapeutic implications in prostatic disease. Prostate Suppl. 2000;9:42–6. https://doi.org/10.1002/1097-0045(2000)45:9+%3c42::aid-pros9%3e3.0.co;2-u.

    Article  CAS  PubMed  Google Scholar 

  24. Roehrborn CG, Siami P, Barkin J, Damião R, Major-Walker K, Nandy I, et al. The effects of combination therapy with dutasteride and tamsulosin on clinical outcomes in men with symptomatic benign prostatic hyperplasia: 4-year results from the CombAT study. Eur Urol. 2010;57:123–31. https://doi.org/10.1016/j.eururo.2009.09.035.

    Article  CAS  PubMed  Google Scholar 

  25. Roehrborn CG, Siami P, Barkin J, Damião R, Major-Walker K, Morrill B, et al. The effects of dutasteride, tamsulosin and combination therapy on lower urinary tract symptoms in men with benign prostatic hyperplasia and prostatic enlargement: 2-year results from the CombAT study. J Urol. 2008;179:616–21. https://doi.org/10.1016/j.juro.2007.09.084. (discussion 621).

    Article  CAS  PubMed  Google Scholar 

  26. Roehrborn CG. Three months’ treatment with the alpha1-blocker alfuzosin does not affect total or transition zone volume of the prostate. Prostate Cancer Prostat Dis. 2006;9:121–5. https://doi.org/10.1038/sj.pcan.4500849.

    Article  CAS  Google Scholar 

  27. Boyle P, Robertson C, Manski R, Padley RJ, Roehrborn CG. Meta-analysis of randomized trials of terazosin in the treatment of benign prostatic hyperplasia. Urology. 2001;58:717–22. https://doi.org/10.1016/s0090-4295(01)01344-9.

    Article  CAS  PubMed  Google Scholar 

  28. Djavan B, Fong YK, Harik M, Milani S, Reissigl A, Chaudry A, et al. Longitudinal study of men with mild symptoms of bladder outlet obstruction treated with watchful waiting for four years. Urology. 2004;64:1144–8. https://doi.org/10.1016/j.urology.2004.08.049.

    Article  PubMed  Google Scholar 

  29. Michel MC, Mehlburger L, Bressel H-U, Goepel M. Comparison of tamsulosin efficacy in subgroups of patients with lower urinary tract symptoms. Prostate Cancer Prostat Dis. 1998;1:332–5. https://doi.org/10.1038/sj.pcan.4500267.

    Article  CAS  Google Scholar 

  30. Yuan J-Q, Mao C, Wong SY-S, Yang Z-Y, Fu X-H, Dai X-Y, et al. Comparative effectiveness and safety of monodrug therapies for lower urinary tract symptoms associated with benign prostatic hyperplasia: a network meta-analysis. Medicine (Baltimore). 2015;94:e974. https://doi.org/10.1097/MD.0000000000000974.

  31. Hennenberg M, Acevedo A, Wiemer N, Kan A, Tamalunas A, Wang Y, et al. Non-adrenergic, tamsulosin-insensitive smooth muscle contraction is sufficient to replace α1 -adrenergic tension in the human prostate. Prostate. 2017;77:697–707. https://doi.org/10.1002/pros.23293.

    Article  CAS  PubMed  Google Scholar 

  32. Tamalunas A, Sauckel C, Ciotkowska A, Rutz B, Wang R, Huang R, et al. Lenalidomide and pomalidomide inhibit growth of prostate stromal cells and human prostate smooth muscle contraction. Life Sci. 2021;281:119771. https://doi.org/10.1016/j.lfs.2021.119771.

    Article  CAS  PubMed  Google Scholar 

  33. Tamalunas A, Sauckel C, Ciotkowska A, Rutz B, Wang R, Huang R, et al. Inhibition of human prostate stromal cell growth and smooth muscle contraction by thalidomide: a novel remedy in LUTS? Prostate. 2021;81:377–89. https://doi.org/10.1002/pros.24114.

    Article  CAS  PubMed  Google Scholar 

  34. Lee M. Tamsulosin for the treatment of benign prostatic hypertrophy. Ann Pharmacother. 2000;34:188–99. https://doi.org/10.1345/aph.18263.

    Article  CAS  PubMed  Google Scholar 

  35. Roehrborn CG, Van Kerrebroeck P, Nordling J. Safety and efficacy of alfuzosin 10 mg once-daily in the treatment of lower urinary tract symptoms and clinical benign prostatic hyperplasia: a pooled analysis of three double-blind, placebo-controlled studies. BJU Int. 2003;92:257–61. https://doi.org/10.1046/j.1464-410x.2003.04309.x.

    Article  CAS  PubMed  Google Scholar 

  36. Marks LS, Gittelman MC, Hill LA, Volinn W, Hoel G. Rapid efficacy of the highly selective alpha1A-adrenoceptor antagonist silodosin in men with signs and symptoms of benign prostatic hyperplasia: pooled results of 2 phase 3 studies. J Urol. 2009;181:2634–40. https://doi.org/10.1016/j.juro.2009.02.034.

    Article  CAS  PubMed  Google Scholar 

  37. Lucas MG, Stephenson TP, Nargund V. Tamsulosin in the management of patients in acute urinary retention from benign prostatic hyperplasia. BJU Int. 2005;95:354–7. https://doi.org/10.1111/j.1464-410X.2005.05299.x.

    Article  CAS  PubMed  Google Scholar 

  38. McNeill SA, Hargreave TB, Roehrborn CG. Alfuzosin 10 mg once daily in the management of acute urinary retention: Results of a double-blind placebo-controlled study. Urology. 2005;65:83–9. https://doi.org/10.1016/j.urology.2004.07.042.

    Article  CAS  PubMed  Google Scholar 

  39. Karavitakis M, Kyriazis I, Omar MI, Gravas S, Cornu J-N, Drake MJ, et al. Management of urinary retention in patients with benign prostatic obstruction: a systematic review and meta-analysis. Eur Urol. 2019;75:788–98. https://doi.org/10.1016/j.eururo.2019.01.046.

    Article  PubMed  Google Scholar 

  40. Boyle P, Gould AL, Roehrborn CG. Prostate volume predicts outcome of treatment of benign prostatic hyperplasia with finasteride: meta-analysis of randomized clinical trials. Urology. 1996;48:398–405. https://doi.org/10.1016/s0090-4295(96)00353-6.

    Article  CAS  PubMed  Google Scholar 

  41. Nickel JC, Gilling P, Tammela TL, Morrill B, Wilson TH, Rittmaster RS. Comparison of dutasteride and finasteride for treating benign prostatic hyperplasia: the Enlarged Prostate International Comparator Study (EPICS). BJU Int. 2011;108:388–94. https://doi.org/10.1111/j.1464-410X.2011.10195.x.

    Article  CAS  PubMed  Google Scholar 

  42. Naslund MJ, Miner M. A review of the clinical efficacy and safety of 5alpha-reductase inhibitors for the enlarged prostate. Clin Ther. 2007;29:17–25. https://doi.org/10.1016/j.clinthera.2007.01.018.

    Article  CAS  PubMed  Google Scholar 

  43. McConnell JD, Bruskewitz R, Walsh P, Andriole G, Lieber M, Holtgrewe HL, et al. The effect of finasteride on the risk of acute urinary retention and the need for surgical treatment among men with benign prostatic hyperplasia. Finasteride Long-Term Efficacy and Safety Study Group. N Engl J Med. 1998;338:557–63. https://doi.org/10.1056/NEJM199802263380901.

    Article  CAS  PubMed  Google Scholar 

  44. McConnell JD, Roehrborn CG, Bautista OM, Andriole GL, Dixon CM, Kusek JW, et al. The long-term effect of doxazosin, finasteride, and combination therapy on the clinical progression of benign prostatic hyperplasia. N Engl J Med. 2003;349:2387–98. https://doi.org/10.1056/NEJMoă56.

    Article  CAS  PubMed  Google Scholar 

  45. Donohue JF, Sharma H, Abraham R, Natalwala S, Thomas DR, Foster MC. Transurethral prostate resection and bleeding: a randomized, placebo controlled trial of role of finasteride for decreasing operative blood loss. J Urol. 2002;168:2024–6. https://doi.org/10.1097/01.ju.0000028607.29093.56.

    Article  PubMed  Google Scholar 

  46. Diviccaro S, Melcangi RC, Giatti S. Post-finasteride syndrome: an emerging clinical problem. Neurobiol Stress. 2020;12:100209. https://doi.org/10.1016/j.ynstr.2019.100209.

    Article  PubMed  Google Scholar 

  47. Nguyen D-D, Marchese M, Cone EB, Paciotti M, Basaria S, Bhojani N, et al. Investigation of suicidality and psychological adverse events in patients treated with finasteride. JAMA Dermatol. 2021;157:35–42. https://doi.org/10.1001/jamadermatol.2020.3385.

    Article  PubMed  Google Scholar 

  48. Oelke M, Shinghal R, Sontag A, Baygani SK, Donatucci CF. Time to onset of clinically meaningful improvement with tadalafil 5 mg once daily for lower urinary tract symptoms secondary to benign prostatic hyperplasia: analysis of data pooled from 4 pivotal, double-blind, placebo controlled studies. J Urol. 2015;193:1581–9. https://doi.org/10.1016/j.juro.2014.11.094.

    Article  CAS  PubMed  Google Scholar 

  49. Oelke M, Wagg A, Takita Y, Büttner H, Viktrup L. Efficacy and safety of tadalafil 5 mg once daily in the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia in men aged ≥75 years: integrated analyses of pooled data from multinational, randomized, placebo-controlled clinical studies. BJU Int. 2017;119:793–803. https://doi.org/10.1111/bju.13744.

    Article  CAS  PubMed  Google Scholar 

  50. Gacci M, Corona G, Salvi M, Vignozzi L, McVary KT, Kaplan SA, et al. A systematic review and meta-analysis on the use of phosphodiesterase 5 inhibitors alone or in combination with α-blockers for lower urinary tract symptoms due to benign prostatic hyperplasia. Eur Urol. 2012;61:994–1003. https://doi.org/10.1016/j.eururo.2012.02.033.

    Article  CAS  PubMed  Google Scholar 

  51. Wang Y, Bao Y, Liu J, Duan L, Cui Y. Tadalafil 5 mg once daily improves lower urinary tract symptoms and erectile dysfunction: a systematic review and meta-analysis. Low Urin Tract Symptoms. 2018;10:84–92. https://doi.org/10.1111/luts.12144.

    Article  CAS  PubMed  Google Scholar 

  52. Gacci M, Sebastianelli A, Salvi M, Schiavina R, Brunocilla E, Novara G, et al. Tolterodine in the treatment of male LUTS. Curr Urol Rep. 2015;16:60. https://doi.org/10.1007/s11934-015-0531-9.

    Article  PubMed  Google Scholar 

  53. Höfner K, Burkart M, Jacob G, Jonas U. Safety and efficacy of tolterodine extended release in men with overactive bladder symptoms and presumed non-obstructive benign prostatic hyperplasia. World J Urol. 2007;25:627–33. https://doi.org/10.1007/s00345-007-0212-5.

    Article  CAS  PubMed  Google Scholar 

  54. Kaplan SA, Walmsley K, Te AE. Tolterodine extended release attenuates lower urinary tract symptoms in men with benign prostatic hyperplasia. J Urol. 2005;174:2273–2275. https://doi.org/10.1097/01.ju.0000181823.33224.a0(discussion 2275–2276)

  55. Andersson KE. On the site and mechanism of action of β3-adrenoceptor agonists in the bladder. Int Neurourol J. 2017;21:6–11. https://doi.org/10.5213/inj.1734850.425.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Liao C-H, Kuo H-C. Mirabegron 25 mg monotherapy is safe but less effective in male patients with overactive bladder and bladder outlet obstruction. Urology. 2018;117:115–9. https://doi.org/10.1016/j.urology.2018.03.038.

    Article  PubMed  Google Scholar 

  57. Krhut J, Skugarevská B, Míka D, Lund L, Zvara P. Clinical utility of β3-adrenoreceptor agonists for the treatment of overactive bladder: a review of the evidence and current recommendations. Res Rep Urol. 2022;14:167–75. https://doi.org/10.2147/RRU.S309144.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. Alexandre EC, Kiguti LR, Calmasini FB, Silva FH, da Silva KP, Ferreira R, et al. Mirabegron relaxes urethral smooth muscle by a dual mechanism involving β3 -adrenoceptor activation and α1 -adrenoceptor blockade. Br J Pharmacol. 2016;173:415–28. https://doi.org/10.1111/bph.13367.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. Huang R, Liu Y, Ciotkowska A, Tamalunas A, Waidelich R, Strittmatter F, et al. Concentration-dependent alpha1-adrenoceptor antagonism and inhibition of neurogenic smooth muscle contraction by mirabegron in the human prostate. Front Pharmacol. 2021;12:666047. https://doi.org/10.3389/fphar.2021.666047.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. White WB, Siddiqui E, Tat T, Franks B, Schermer CR. Cardiovascular safety of mirabegron: analysis of an integrated clinical trial database of patients with overactive bladder syndrome. J Am Soc Hypertens JASH. 2018;12:768-778.e1. https://doi.org/10.1016/j.jash.2018.08.001.

    Article  CAS  PubMed  Google Scholar 

  61. Kaplan SA, Lee JY, Meehan AG, Kusek JW. Time course of incident adverse experiences associated with doxazosin, finasteride and combination therapy in men with benign prostatic hyperplasia: the MTOPS trial. J Urol. 2016;195:1825–9. https://doi.org/10.1016/j.juro.2015.11.065.

    Article  CAS  PubMed  Google Scholar 

  62. van Kerrebroeck P, Chapple C, Drogendijk T, Klaver M, Sokol R, Speakman M, et al. Combination therapy with solifenacin and tamsulosin oral controlled absorption system in a single tablet for lower urinary tract symptoms in men: efficacy and safety results from the randomised controlled NEPTUNE trial. Eur Urol. 2013;64:1003–12. https://doi.org/10.1016/j.eururo.2013.07.034.

    Article  CAS  PubMed  Google Scholar 

  63. Van Kerrebroeck P, Haab F, Angulo JC, Vik V, Katona F, Garcia-Hernandez A, et al. Efficacy and safety of solifenacin plus tamsulosin OCAS in men with voiding and storage lower urinary tract symptoms: results from a phase 2, dose-finding study (SATURN). Eur Urol. 2013;64:398–407. https://doi.org/10.1016/j.eururo.2013.03.031.

    Article  CAS  PubMed  Google Scholar 

  64. Kim HJ, Sun HY, Choi H, Park JY, Bae JH, Doo SW, et al. Efficacy and safety of initial combination treatment of an alpha blocker with an anticholinergic medication in benign prostatic hyperplasia patients with lower urinary tract symptoms: updated meta-analysis. PLoS ONE. 2017;12:e0169248. https://doi.org/10.1371/journal.pone.0169248.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Kaplan SA, Herschorn S, McVary KT, Staskin D, Chapple C, Foley S, et al. Efficacy and safety of mirabegron versus placebo add-on therapy in men with overactive bladder symptoms receiving tamsulosin for underlying benign prostatic hyperplasia: a randomized, phase 4 study (PLUS). J Urol. 2020;203:1163–71. https://doi.org/10.1097/JU.0000000000000738.

    Article  PubMed  Google Scholar 

  66. Kakizaki H, Lee K-S, Yamamoto O, Jong JJ, Katou D, Sumarsono B, et al. Mirabegron add-on therapy to tamsulosin for the treatment of overactive bladder in men with lower urinary tract symptoms: a randomized, placebo-controlled study (MATCH). Eur Urol Focus. 2020;6:729–37. https://doi.org/10.1016/j.euf.2019.10.019.

    Article  PubMed  Google Scholar 

  67. van Gelderen M, Tretter R, Meijer J, Dorrepaal C, Gangaram-Panday S, Brooks A, et al. Absence of clinically relevant cardiovascular interaction upon add-on of mirabegron or tamsulosin to an established tamsulosin or mirabegron treatment in healthy middle-aged to elderly men. Int J Clin Pharmacol Ther. 2014;52:693–701. https://doi.org/10.5414/CP201979.

    Article  CAS  PubMed  Google Scholar 

  68. Huang R, Tamalunas A, Waidelich R, Strittmatter F, Stief CG, Hennenberg M. Antagonism of α1-adrenoceptors by β3-adrenergic agonists: structure-function relations of different agonists in prostate smooth muscle contraction. Biochem Pharmacol. 2022;202:115148. https://doi.org/10.1016/j.bcp.2022.115148.

    Article  CAS  PubMed  Google Scholar 

  69. Huang R, Tamalunas A, Waidelich R, Strittmatter F, Stief CG, Hennenberg M. Inhibition of full smooth muscle contraction in isolated human detrusor tissues by mirabegron is limited to off-target inhibition of neurogenic contractions. J Pharmacol Exp Ther. 2022;381:176–87. https://doi.org/10.1124/jpet.121.001029.

    Article  CAS  PubMed  Google Scholar 

  70. Tamalunas A, Wendt A, Springer F, Ciotkowska A, Rutz B, Wang R, et al. Inhibition of human prostate and bladder smooth muscle contraction, vasoconstriction of porcine renal and coronary arteries, and growth-related functions of prostate stromal cells by presumed small molecule Gαq/11 inhibitor, YM-254890. Front Physiol. 2022;13:884057. https://doi.org/10.3389/fphys.2022.884057.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Madersbacher S, Berger I, Ponholzer A, Marszalek M. Plant extracts: sense or nonsense? Curr Opin Urol. 2008;18:16–20. https://doi.org/10.1097/MOU.0b013e3282f0d5c8.

    Article  PubMed  Google Scholar 

  72. Scaglione F, Lucini V, Pannacci M, Caronno A, Leone C. Comparison of the potency of different brands of Serenoa repens extract on 5alpha-reductase types I and II in prostatic co-cultured epithelial and fibroblast cells. Pharmacology. 2008;82:270–5. https://doi.org/10.1159/000161128.

    Article  CAS  PubMed  Google Scholar 

  73. Habib FK, Wyllie MG. Not all brands are created equal: a comparison of selected components of different brands of Serenoa repens extract. Prostate Cancer Prostat Dis. 2004;7:195–200. https://doi.org/10.1038/sj.pcan.4500746.

    Article  CAS  Google Scholar 

  74. Tamalunas A, Wendt A, Springer F, Vigodski V, Ciotkowska A, Rutz B, et al. Permixon®, hexane-extracted Serenoa repens, inhibits human prostate and bladder smooth muscle contraction and exerts growth-related functions in human prostate stromal cells. Life Sci. 2022;308:120931. https://doi.org/10.1016/j.lfs.2022.120931.

    Article  CAS  PubMed  Google Scholar 

  75. Schoendorfer N, Sharp N, Seipel T, Schauss AG, Ahuja KDK. Urox containing concentrated extracts of Crataeva nurvala stem bark, Equisetum arvense stem and Lindera aggregata root, in the treatment of symptoms of overactive bladder and urinary incontinence: a phase 2, randomised, double-blind placebo controlled trial. BMC Complement Altern Med. 2018;18:42. https://doi.org/10.1186/s12906-018-2101-4.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Cornu J-N, Ahyai S, Bachmann A, de la Rosette J, Gilling P, Gratzke C, et al. A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction: an update. Eur Urol. 2015;67:1066–96. https://doi.org/10.1016/j.eururo.2014.06.017.

    Article  PubMed  Google Scholar 

  77. Hahn RG. The transurethral resection syndrome. Acta Anaesthesiol Scand. 1991;35:557–67. https://doi.org/10.1111/j.1399-6576.1991.tb03348.x.

    Article  CAS  PubMed  Google Scholar 

  78. Madersbacher S, Marberger M. Is transurethral resection of the prostate still justified? BJU Int. 1999;83:227–37. https://doi.org/10.1046/j.1464-410x.1999.00908.x.

    Article  CAS  PubMed  Google Scholar 

  79. Reich O, Gratzke C, Bachmann A, Seitz M, Schlenker B, Hermanek P, et al. Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10,654 patients. J Urol. 2008;180:246–9. https://doi.org/10.1016/j.juro.2008.03.058.

    Article  PubMed  Google Scholar 

  80. Alexander CE, Scullion MM, Omar MI, Yuan Y, Mamoulakis C, N’Dow JM, et al. Bipolar versus monopolar transurethral resection of the prostate for lower urinary tract symptoms secondary to benign prostatic obstruction. Cochrane Database Syst Rev. 2019. https://doi.org/10.1002/14651858.CD009629.pub4.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Bach T, Muschter R, Sroka R, Gravas S, Skolarikos A, Herrmann TRW, et al. Laser treatment of benign prostatic obstruction: basics and physical differences. Eur Urol. 2012;61:317–25. https://doi.org/10.1016/j.eururo.2011.10.009.

    Article  PubMed  Google Scholar 

  82. Xia S-J, Zhuo J, Sun X-W, Han B-M, Shao Y, Zhang Y-N. Thulium laser versus standard transurethral resection of the prostate: a randomized prospective trial. Eur Urol. 2008;53:382–9. https://doi.org/10.1016/j.eururo.2007.05.019.

    Article  PubMed  Google Scholar 

  83. Deng Z, Sun M, Zhu Y, Zhuo J, Zhao F, Xia S, et al. Thulium laser VapoResection of the prostate versus traditional transurethral resection of the prostate or transurethral plasmakinetic resection of prostate for benign prostatic obstruction: a systematic review and meta-analysis. World J Urol. 2018;36:1355–64. https://doi.org/10.1007/s00345-018-2287-6.

    Article  CAS  PubMed  Google Scholar 

  84. Bansal A, Sankhwar S, Kumar M, Jhanwar A, Purkait B, Aeron R, et al. Holmium laser vs monopolar electrocautery bladder neck incision for prostates less than 30 grams: a prospective randomized trial. Urology. 2016;93:158–63. https://doi.org/10.1016/j.urology.2016.03.042.

    Article  PubMed  Google Scholar 

  85. Lourenco T, Shaw M, Fraser C, MacLennan G, N’Dow J, Pickard R. The clinical effectiveness of transurethral incision of the prostate: a systematic review of randomised controlled trials. World J Urol. 2010;28:23–32. https://doi.org/10.1007/s00345-009-0496-8.

    Article  PubMed  Google Scholar 

  86. Gratzke C, Schlenker B, Seitz M, Karl A, Hermanek P, Lack N, et al. Complications and early postoperative outcome after open prostatectomy in patients with benign prostatic enlargement: results of a prospective multicenter study. J Urol. 2007;177:1419–22. https://doi.org/10.1016/j.juro.2006.11.062.

    Article  PubMed  Google Scholar 

  87. Lin Y, Wu X, Xu A, Ren R, Zhou X, Wen Y, et al. Transurethral enucleation of the prostate versus transvesical open prostatectomy for large benign prostatic hyperplasia: a systematic review and meta-analysis of randomized controlled trials. World J Urol. 2016;34:1207–19. https://doi.org/10.1007/s00345-015-1735-9.

    Article  PubMed  Google Scholar 

  88. Varkarakis I, Kyriakakis Z, Delis A, Protogerou V, Deliveliotis C. Long-term results of open transvesical prostatectomy from a contemporary series of patients. Urology. 2004;64:306–10. https://doi.org/10.1016/j.urology.2004.03.033.

    Article  PubMed  Google Scholar 

  89. Lucca I, Shariat SF, Hofbauer SL, Klatte T. Outcomes of minimally invasive simple prostatectomy for benign prostatic hyperplasia: a systematic review and meta-analysis. World J Urol. 2015;33:563–70. https://doi.org/10.1007/s00345-014-1324-3.

    Article  PubMed  Google Scholar 

  90. Kordan Y, Canda AE, Köseoğlu E, Balbay D, Laguna MP, de la Rosette J. Robotic-assisted simple prostatectomy: a systematic review. J Clin Med. 2020;9:1798. https://doi.org/10.3390/jcm9061798.

    Article  PubMed  PubMed Central  Google Scholar 

  91. Scarcella S, Castellani D, Gauhar V, Teoh JY-C, Giulioni C, Piazza P, et al. Robotic-assisted versus open simple prostatectomy: Results from a systematic review and meta-analysis of comparative studies. Investig Clin Urol. 2021;62:631–40. https://doi.org/10.4111/icu.20210297.

  92. Elhilali MM, Badaan S, Ibrahim A, Andonian S. Use of the Moses technology to improve holmium laser lithotripsy outcomes: a preclinical study. J Endourol. 2017;31:598–604. https://doi.org/10.1089/end.2017.0050.

    Article  PubMed  PubMed Central  Google Scholar 

  93. Tamalunas A, Westhofen T, Schott M, Keller P, Atzler M, Stief CG, et al. Holmium laser enucleation of the prostate: a truly size-independent method? Low Urin Tract Symptoms. 2022;14:17–26. https://doi.org/10.1111/luts.12404.

    Article  PubMed  Google Scholar 

  94. Becker B, Netsch C, Bozzini G, Herrmann TRW, Bach T, Enikeev D, et al. Reasons to go for thulium-based anatomical endoscopic enucleation of the prostate. World J Urol. 2021;39:2363–74. https://doi.org/10.1007/s00345-021-03704-7.

    Article  CAS  PubMed  Google Scholar 

  95. Tamalunas A, Schott M, Keller P, Atzler M, Ebner B, Hennenberg M, et al. Efficacy, efficiency, and safety of en-bloc vs three-lobe enucleation of the prostate: a propensity score-matched analysis. Urology. 2023;175:48–55. https://doi.org/10.1016/j.urology.2023.02.014.

    Article  PubMed  Google Scholar 

  96. Chen C-H, Chung C-H, Chu H-C, Chen K-C, Ho C-H. Surgical outcome of anatomical endoscopic enucleation of the prostate: a systemic review and meta-analysis. Andrologia. 2020;52:e13612. https://doi.org/10.1111/and.13612.

    Article  PubMed  Google Scholar 

  97. Ibrahim A, Alharbi M, Elhilali MM, Aubé M, Carrier S. 18 years of holmium laser enucleation of the prostate: a single center experience. J Urol. 2019;202:795–800. https://doi.org/10.1097/JU.0000000000000280.

    Article  PubMed  Google Scholar 

  98. Gilling PJ, Wilson LC, King CJ, Westenberg AM, Frampton CM, Fraundorfer MR. Long-term results of a randomized trial comparing holmium laser enucleation of the prostate and transurethral resection of the prostate: results at 7 years. BJU Int. 2012;109:408–11. https://doi.org/10.1111/j.1464-410X.2011.10359.x.

    Article  PubMed  Google Scholar 

  99. Zhu L, Chen S, Yang S, Wu M, Ge R, Wu W, et al. Electrosurgical enucleation versus bipolar transurethral resection for prostates larger than 70 ml: a prospective, randomized trial with 5-year followup. J Urol. 2013;189:1427–31. https://doi.org/10.1016/j.juro.2012.10.117.

    Article  PubMed  Google Scholar 

  100. Elshal AM, Soltan M, El-Tabey NA, Laymon M, Nabeeh A. Randomised trial of bipolar resection vs holmium laser enucleation vs Greenlight laser vapo-enucleation of the prostate for treatment of large benign prostate obstruction: 3-years outcomes. BJU Int. 2020;126:731–8. https://doi.org/10.1111/bju.15161.

    Article  CAS  PubMed  Google Scholar 

  101. El Tayeb MM, Jacob JM, Bhojani N, Bammerlin E, Lingeman JE. Holmium laser enucleation of the prostate in patients requiring anticoagulation. J Endourol. 2016;30:805–9. https://doi.org/10.1089/end.2016.0070.

    Article  PubMed  Google Scholar 

  102. Kuebker JM, Miller NL. Holmium laser enucleation of the prostate: patient selection and outcomes. Curr Urol Rep. 2017;18:96. https://doi.org/10.1007/s11934-017-0746-z.

    Article  PubMed  Google Scholar 

  103. Romero-Otero J, García-González L, García-Gómez B, Justo-Quintas J, García-Rojo E, González-Padilla DA, et al. Factors influencing intraoperative blood loss in patients undergoing holmium Laser Enucleation of the Prostate (HoLEP) for benign prostatic hyperplasia: a large multicenter analysis. Urology. 2019;132:177–82. https://doi.org/10.1016/j.urology.2019.06.024.

    Article  PubMed  Google Scholar 

  104. Elzayat EA, Elhilali MM. Holmium Laser Enucleation of the Prostate (HoLEP): long-term results, reoperation rate, and possible impact of the learning curve. Eur Urol. 2007;52:1465–72. https://doi.org/10.1016/j.eururo.2007.04.074.

    Article  PubMed  Google Scholar 

  105. Thomas JA, Tubaro A, Barber N, d’Ancona F, Muir G, Witzsch U, et al. A multicenter randomized noninferiority trial comparing GreenLight-XPS laser vaporization of the prostate and transurethral resection of the prostate for the treatment of benign prostatic obstruction: two-yr outcomes of the GOLIATH study. Eur Urol. 2016;69:94–102. https://doi.org/10.1016/j.eururo.2015.07.054.

    Article  PubMed  Google Scholar 

  106. Ajib K, Mansour M, Zanaty M, Alnazari M, Hueber P-A, Meskawi M, et al. Photoselective vaporization of the prostate with the 180-W XPS-Greenlight laser: Five-year experience of safety, efficiency, and functional outcomes. Can Urol Assoc J J Assoc Urol Can. 2018;12:E318–24. https://doi.org/10.5489/cuaj.4895.

    Article  Google Scholar 

  107. Bachmann A, Schürch L, Ruszat R, Wyler SF, Seifert H-H, Müller A, et al. Photoselective vaporization (PVP) versus transurethral resection of the prostate (TURP): a prospective bi-centre study of perioperative morbidity and early functional outcome. Eur Urol. 2005;48:965–71. https://doi.org/10.1016/j.eururo.2005.07.001. (discussion 972).

    Article  PubMed  Google Scholar 

  108. Rajih E, Tholomier C, Hueber P-A, Alenizi AM, Valdivieso R, Azizi M, et al. Evaluation of surgical outcomes with photoselective GreenLight XPS laser vaporization of the prostate in high medical risk men with benign prostatic enlargement: a multicenter study. J Endourol. 2017;31:686–93. https://doi.org/10.1089/end.2016.0782.

    Article  PubMed  Google Scholar 

  109. Nguyen D-D, Sadri I, Law K, Bhojani N, Elterman DS, Zakaria AS, et al. Impact of the presence of a median lobe on functional outcomes of greenlight photovaporization of the prostate (PVP): an analysis of the Global Greenlight Group (GGG) Database. World J Urol. 2021;39:3881–9. https://doi.org/10.1007/s00345-020-03529-w.

    Article  PubMed  Google Scholar 

  110. Robert G, de la Taille A, Herrmann T. Bipolar plasma vaporization of the prostate: ready to replace GreenLight? A systematic review of randomized control trials. World J Urol. 2015;33:549–54. https://doi.org/10.1007/s00345-014-1384-4.

    Article  PubMed  Google Scholar 

  111. MacRae C, Gilling P. How I do it: aquablation of the prostate using the AQUABEAM system. Can J Urol. 2016;23:8590–3.

    PubMed  Google Scholar 

  112. Gilling P, Barber N, Bidair M, Anderson P, Sutton M, Aho T, et al. WATER: a double-blind, randomized, controlled trial of Aquablation® vs transurethral resection of the prostate in benign prostatic hyperplasia. J Urol. 2018;199:1252–61. https://doi.org/10.1016/j.juro.2017.12.065.

    Article  PubMed  Google Scholar 

  113. Pisco JM, Rio Tinto H, Campos Pinheiro L, Bilhim T, Duarte M, Fernandes L, et al. Embolisation of prostatic arteries as treatment of moderate to severe lower urinary symptoms (LUTS) secondary to benign hyperplasia: results of short- and mid-term follow-up. Eur Radiol. 2013;23:2561–72. https://doi.org/10.1007/s00330-012-2714-9.

    Article  PubMed  Google Scholar 

  114. Gao Y, Huang Y, Zhang R, Yang Y, Zhang Q, Hou M, et al. Benign prostatic hyperplasia: prostatic arterial embolization versus transurethral resection of the prostate–a prospective, randomized, and controlled clinical trial. Radiology. 2014;270:920–8. https://doi.org/10.1148/radiol.13122803.

    Article  PubMed  Google Scholar 

  115. Carnevale FC, Iscaife A, Yoshinaga EM, Moreira AM, Antunes AA, Srougi M. Transurethral resection of the prostate (TURP) versus original and PErFecTED prostate artery embolization (PAE) due to benign prostatic hyperplasia (BPH): preliminary results of a single center, prospective, urodynamic-controlled analysis. Cardiovasc Intervent Radiol. 2016;39:44–52. https://doi.org/10.1007/s00270-015-1202-4.

    Article  PubMed  Google Scholar 

  116. Russo GI, Kurbatov D, Sansalone S, Lepetukhin A, Dubsky S, Sitkin I, et al. Prostatic arterial embolization vs open prostatectomy: a 1-year matched-pair analysis of functional outcomes and morbidities. Urology. 2015;86:343–8. https://doi.org/10.1016/j.urology.2015.04.037.

    Article  PubMed  Google Scholar 

  117. Bhatia S, Sinha VK, Harward S, Gomez C, Kava BR, Parekh DJ. Prostate artery embolization in patients with prostate volumes of 80 ml or more: a single-institution retrospective experience of 93 patients. J Vasc Interv Radiol JVIR. 2018;29:1392–8. https://doi.org/10.1016/j.jvir.2018.05.012.

    Article  PubMed  Google Scholar 

  118. Abt D, Hechelhammer L, Müllhaupt G, Markart S, Güsewell S, Kessler TM, et al. Comparison of prostatic artery embolisation (PAE) versus transurethral resection of the prostate (TURP) for benign prostatic hyperplasia: randomised, open label, non-inferiority trial. BMJ. 2018;361:k2338. https://doi.org/10.1136/bmj.k2338.

    Article  PubMed  PubMed Central  Google Scholar 

  119. McVary KT, Gange SN, Gittelman MC, Goldberg KA, Patel K, Shore ND, et al. Minimally invasive prostate convective water vapor energy ablation: a multicenter, randomized, controlled study for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia. J Urol. 2016;195:1529–38. https://doi.org/10.1016/j.juro.2015.10.181.

    Article  PubMed  Google Scholar 

  120. McVary KT, Gange SN, Gittelman MC, Goldberg KA, Patel K, Shore ND, et al. Erectile and ejaculatory function preserved with convective water vapor energy treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia: randomized controlled study. J Sex Med. 2016;13:924–33. https://doi.org/10.1016/j.jsxm.2016.03.372.

    Article  PubMed  Google Scholar 

  121. McVary KT, Gittelman MC, Goldberg KA, Patel K, Shore ND, Levin RM, et al. Final 5-Year outcomes of the multicenter randomized sham-controlled trial of a water vapor thermal therapy for treatment of moderate to severe lower urinary tract symptoms secondary to benign prostatic hyperplasia. J Urol. 2021;206:715–24. https://doi.org/10.1097/JU.0000000000001778.

    Article  PubMed  Google Scholar 

  122. Kang TW, Jung JH, Hwang EC, Borofsky M, Kim MH, Dahm P. Convective radiofrequency water vapour thermal therapy for lower urinary tract symptoms in men with benign prostatic hyperplasia. Cochrane Database Syst Rev. 2020;3:CD013251. https://doi.org/10.1002/14651858.CD013251.pub2.

    Article  PubMed  Google Scholar 

  123. Sønksen J, Barber NJ, Speakman MJ, Berges R, Wetterauer U, Greene D, et al. Prospective, randomized, multinational study of prostatic urethral lift versus transurethral resection of the prostate: 12-month results from the BPH6 study. Eur Urol. 2015;68:643–52. https://doi.org/10.1016/j.eururo.2015.04.024.

    Article  PubMed  Google Scholar 

  124. Roehrborn CG, Barkin J, Gange SN, Shore ND, Giddens JL, Bolton DM, et al. Five year results of the prospective randomized controlled prostatic urethral L.I.F.T. study. Can J Urol. 2017;24:8802–13.

    PubMed  Google Scholar 

  125. Rukstalis D, Grier D, Stroup SP, Tutrone R, deSouza E, Freedman S, et al. Prostatic urethral lift (PUL) for obstructive median lobes: 12 month results of the MedLift study. Prostate Cancer Prostat Dis. 2019;22:411–9. https://doi.org/10.1038/s41391-018-0118-x.

    Article  Google Scholar 

  126. Amparore D, Fiori C, Valerio M, Schulman C, Giannakis I, De Cillis S, et al. 3-Year results following treatment with the second generation of the temporary implantable nitinol device in men with LUTS secondary to benign prostatic obstruction. Prostate Cancer Prostat Dis. 2021;24:349–57. https://doi.org/10.1038/s41391-020-00281-5.

    Article  CAS  Google Scholar 

  127. De Nunzio C, Cantiello F, Fiori C, Crocerossa F, Tognoni P, Amparore D, et al. Urinary and sexual function after treatment with temporary implantable nitinol device (iTind) in men with LUTS: 6-month interim results of the MT-06-study. World J Urol. 2021;39:2037–42. https://doi.org/10.1007/s00345-020-03418-2.

    Article  CAS  PubMed  Google Scholar 

  128. Chughtai B, Elterman D, Shore N, Gittleman M, Motola J, Pike S, et al. The iTind temporarily implanted nitinol device for the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia: a multicenter, randomized, controlled trial. Urology. 2021;153:270–6. https://doi.org/10.1016/j.urology.2020.12.022.

    Article  PubMed  Google Scholar 

  129. Rubeinstein JN, McVary KT. Transurethral microwave thermotherapy for benign prostatic hyperplasia. Int Braz J Urol Off J Braz Soc Urol. 2003;29:251–63. https://doi.org/10.1590/s1677-55382003000300013.

    Article  Google Scholar 

  130. Gravas S, Laguna P, Kiemeney LALM, de la Rosette JJMCH. Durability of 30-minute high-energy transurethral microwave therapy for treatment of benign prostatic hyperplasia: a study of 213 patients with and without urinary retention. Urology. 2007;69:854–8. https://doi.org/10.1016/j.urology.2007.01.070.

  131. Vanderbrink BA, Rastinehad AR, Badlani GH. Prostatic stents for the treatment of benign prostatic hyperplasia. Curr Opin Urol. 2007;17:1–6. https://doi.org/10.1097/MOU.0b013e3280117747.

    Article  PubMed  Google Scholar 

  132. Magistro G, Stief CG, Gratzke C. New intraprostatic injectables and prostatic urethral lift for male LUTS. Nat Rev Urol. 2015;12:461–71. https://doi.org/10.1038/nrurol.2015.169.

    Article  PubMed  Google Scholar 

  133. Shore N, Tutrone R, Efros M, Bidair M, Wachs B, Kalota S, et al. Fexapotide triflutate: results of long-term safety and efficacy trials of a novel injectable therapy for symptomatic prostate enlargement. World J Urol. 2018;36:801–9. https://doi.org/10.1007/s00345-018-2185-y.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  134. Zenflow Spring System shows promising results in early trials for patients with BPH. Urol Times 2021. https://www.urologytimes.com/view/zenflow-spring-system-shows-promising-results-in-early-trials-for-patients-with-bph. Accessed 15 Mar 2023.

  135. Woo HH, Huang C-P, Huang WJ, Chang Y-H, Lien C-S, Chkhotua A, et al. The EXPANDER-1 trial: introduction of the novel UrocrossTM Expander System for treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). Prostate Cancer Prostat Dis. 2022;25:576–82. https://doi.org/10.1038/s41391-022-00548-z.

    Article  CAS  Google Scholar 

  136. New hope for enlarged prostate: Avant enrolls world’s first patient in the ProVIDE clinical trial | Avant Concierge Urology: Sijo J. Parekattil, MD 2022. https://avanturol.com/new-hope-for-enlarged-prostate-avant-enrolls-worlds-first-patient-in-the-provide-clinical-trial/. Accessed 15 Mar 2023.

  137. One-year outcomes after treatment with a drug-coated balloon catheter system for lower urinary tract symptoms related to benign prostatic hyperplasia - PubMed n.d. https://pubmed-ncbi-nlm-nih-gov.proxy3.library.mcgill.ca/33833379/. Accessed 15 Mar 2023.

  138. MP01-02. THE “BUTTERFLY” TRANSURETHRAL RETRACTION DEVICE FOR BPH—OVER 1 YEAR FOLLOW UP|J Urol n.d. https://doi.org/10.1097/JU.0000000000002513.02. Accessed 15 Mar 2023.

  139. Deyirmendjian C, Nguyen D-D, Law KW, Nguyen A-LV, Sadri I, Arezki A, et al. Safety and efficacy of GreenLight PVP in octogenarians: evaluation of the Global GreenLight Group database. World J Urol. 2023. https://doi.org/10.1007/s00345-023-04334-x.

  140. Nguyen D-D, Deyirmendjian C, Law K, Bhojani N, Elterman DS, Chughtai B, et al. GreenLight photovaporization of the prostate in high-medical-risk patients: an analysis of the Global GreenLight Group (GGG) database. World J Urol. 2022;40:1755–62. https://doi.org/10.1007/s00345-022-03986-5.

    Article  PubMed  Google Scholar 

  141. Tamalunas A, Westhofen T, Schott M, Keller P, Atzler M, Stief CG, et al. The clinical value of holmium laser enucleation of the prostate in octogenarians. LUTS Low Urin Tract Symptoms. 2021;13:279–85. https://doi.org/10.1111/luts.12366.

    Article  CAS  PubMed  Google Scholar 

  142. Heiman J, Agarwal D, Komanapalli S, Nottingham C, Large T, Krambeck A, et al. Outcomes of octogenarians undergoing holmium laser enucleation of prostate. World J Urol. 2022;40:1751–4. https://doi.org/10.1007/s00345-022-04053-9.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Dean S. Elterman.

Ethics declarations

Funding

Not applicable.

Conflict of interests

Naeem Bhojani is a consultant for Boston Scientific, Olympus, and Procept BioRobotics; Kevin C. Zorn is a consultant for Boston Scientific, Clarius, Olympus, Zenflow, and Resurge Therapeutics; Bilal Chughtai is a consultant/investigator for Boston Scientific, Prodeon, Olympus, and Resurge; and Dr. Elterman is a consultant/investigator for Boston Scientific, Procept Biorobotics, Olympus, Urotronic, Prodeon, and Zenflow.

Availability of data and material

All of the data and material used in this paper are publicly available and have been referenced appropriately.

Ethics approval

Not applicable.

Consent to participate

Not applicable.

Consent for publication

Not applicable.

Code availability

Not applicable.

Author contributions

All authors have contributed to the development of the concept and design, drafting, and revising of the manuscript: Liam Murad was responsible for acquisition of data, analysis and interpretation of data, drafting of the manuscript, and critical revision of the manuscript; David Bouhadana for drafting of the manuscript and critical revision of the manuscript; David-Dan Nguyen for critical revision of the manuscript; Bilal Chughtai for critical revision of the manuscript; Kevin C. Zorn for critical revision of the manuscript; Naeem Bhojani for critical revision of the manuscript; and Dean S. Elterman for critical revision of the manuscript and supervision. All authors have read and approved the final version of this manuscript.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Murad, L., Bouhadana, D., Nguyen, DD. et al. Treating LUTS in Men with Benign Prostatic Obstruction: A Review Article. Drugs Aging 40, 815–836 (2023). https://doi.org/10.1007/s40266-023-01054-0

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40266-023-01054-0

Navigation