Defining minimal invasive surgical therapy for benign prostatic obstruction surgery: Perspectives from a global knowledge, attitude, and practice survey

Bryan Kwun-Chung Cheng*, Steffi Kar-Kei Yuen, Daniele Castellani, Marcelo Langer Wroclawski, Hongda Zhao, Mallikarjuna Chiruvella, Wei Jin Chua, Ho Yee Tiong, Yiloren Tanidir, Jean de la Rosette, Enrique Rijo, Vincent Misrai, Amy Krambeck, Dean S. Elterman, Bhaskar K. Somani, Jeremy Yuen-Chun Teoh, Vineet Gauhar

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Objective: To scrutinize the definitions of minimal invasive surgical therapy (MIST) and to investigate urologists’ knowledge, attitudes, and practices for benign prostatic obstruction surgeries. Methods: A 36-item survey was developed with a Delphi method. Questions on definitions of MIST and attitudes and practices of benign prostatic obstruction surgeries were included. Urologists were invited globally to complete the online survey. Consensus was achieved when more than or equal to 70% responses were “agree or strongly agree” and less than or equal to 15% responses were “disagree or strongly disagree” (consensus agree), or when more than or equal to 70% responses were “disagree or strongly disagree” and less than or equal to 15% responses were “agree or strongly agree” (consensus disagree). Results: The top three qualities for defining MIST were minimal blood loss (n=466, 80.3%), fast post-operative recovery (n=431, 74.3%), and short hospital stay (n=425, 73.3%). The top three surgeries that were regarded as MIST were Urolift® (n=361, 62.2%), Rezum® (n=351, 60.5%), and endoscopic enucleation of the prostate (EEP) (n=332, 57.2%). Consensus in the knowledge section was achieved for the superiority of Urolift®, Rezum®, and iTIND® over transurethral resection of the prostate with regard to blood loss, recovery, day surgery feasibility, and post-operative continence. Consensus in the attitudes section was achieved for the superiority of Urolift®, Rezum®, and iTIND® over transurethral resection of the prostate with regard to blood loss, recovery, and day surgery feasibility. Consensus on both sections was achieved for EEP as the option with the better symptoms and flow improvement, lower retreatment rate, and better suitable for prostate more than 80 mL. Conclusion: Minimal blood loss, fast post-operative recovery, and short hospital stay were the most important qualities for defining MIST. Urolift®, Rezum®, and EEP were regarded as MIST by most urologists.

Original languageEnglish (US)
Pages (from-to)55-64
Number of pages10
JournalAsian Journal of Urology
Volume11
Issue number1
DOIs
StatePublished - Jan 2024

Keywords

  • Benign prostate hyperplasia
  • Bladder outlet obstruction
  • Minimal invasive surgical therapy
  • Surgery

ASJC Scopus subject areas

  • Urology

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