Making Sense of BPH: Which Treatment for Which Patient?

Making Sense of BPH: A Review of Guidelines for BPH

Seth K. Bechis, MD, reviews the 2023 American Urological Association (AUA) guidelines for benign prostatic hyperplasia (BPH) treatment.

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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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Treating BPH with Rezum

This week on the BackTable Urology Podcast, Dr. Jose Silva invites Dr. Seth Bechis onto the show to discuss the diagnosis and treatment of BPH with Rezum, a minimally invasive surgical that uses water vapor to dissolve prostate tissue

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