Management of Benign Prostatic Hyperplasia and Problems of Transurethral Resection of the Prostate

Abstract

Abstract:

Background: Benign prostatic hyperplasia (BPH) is one of the most prevalent urological disorders affecting middle-aged and older men. It is characterized by non-malignant proliferation of prostatic stromal and epithelial tissues, which may lead to enlargement of the prostate, bladder outlet obstruction, and the development of lower urinary tract symptoms (LUTS). These symptoms commonly include urinary frequency, urgency, nocturia, hesitancy, weak or intermittent urinary stream, straining, incomplete bladder emptying, terminal dribbling, and urinary incontinence. The prevalence and severity of BPH increase markedly with age, making it an important cause of impaired quality of life, sleep disturbance, psychological distress, and reduced daily functioning among elderly men. If inadequately managed, BPH may result in serious complications such as acute urinary retention, recurrent urinary tract infection, bladder stones, hematuria, bladder decompensation, renal insufficiency, and deterioration of the upper urinary tract. Management is individualized according to symptom severity, prostate size, urinary flow, post-void residual urine, associated complications, comorbidities, and patient preference. Available treatment options range from watchful waiting, lifestyle modifications, and pharmacological therapy to minimally invasive procedures and conventional or laser-based surgical interventions. Recent technological advances have expanded therapeutic choices and improved safety, efficacy, recovery time, and preservation of urinary and sexual function. This review discusses the current evaluation and management of BPH, with particular emphasis on medical treatment, bipolar transurethral resection, laser procedures, and emerging minimally invasive interventions.