A Systematic Review on the Timing of Surgical Intervention for Benign Prostatic Enlargement (BPE)

Curr Urol Rep. 2020 Nov 24;21(12):64. doi: 10.1007/s11934-020-01016-8.

Abstract

Purpose of review: Surgical intervention for benign prostatic enlargement (BPE) is typically reserved for those who fail medical therapy (i.e., α-blocker or 5-α reductase inhibitor treatment). We conducted a systematic review to determine whether timing of surgical intervention for BPE affects patient outcomes.

Recent findings: The studies we reviewed suggested that patients who undergo surgical intervention for BPE after failing medical therapy may have worse outcomes. Increased age, worsened bladder function, and worse overall health may contribute to worsened outcomes. To date, there are few high-quality studies on the timing of surgical intervention for BPE in the literature. Further prospective trials are needed to determine ideal timing for intervention.

Keywords: Benign prostatic enlargement; Benign prostatic hyperplasia; Bladder outlet obstruction; Delayed prostatectomy; Lower urinary tract symptoms.

Publication types

  • Systematic Review

MeSH terms

  • 5-alpha Reductase Inhibitors / therapeutic use
  • Adrenergic alpha-Antagonists / therapeutic use
  • Age Factors
  • Humans
  • Male
  • Prostatic Hyperplasia / complications
  • Prostatic Hyperplasia / physiopathology
  • Prostatic Hyperplasia / surgery*
  • Time Factors
  • Treatment Failure
  • Treatment Outcome
  • Urinary Bladder, Underactive / complications
  • Urinary Bladder, Underactive / physiopathology*
  • Urinary Retention / etiology
  • Urinary Retention / physiopathology*

Substances

  • 5-alpha Reductase Inhibitors
  • Adrenergic alpha-Antagonists