Benign prostatic hyperplasia: A review of current trends in surgical management

Benign prostatic hyperplasia (BPH) is a common cause of lower urinary tract symptoms (LUTS) in men. It is a disorder that interferes with normal daily activities, thereby affecting the quality of life of the individual. Multiple modalities of treatment can be utilised. These include lifestyle advice, watchful waiting, medical therapy and surgical therapy. In terms of surgical therapy, varied patient, regional, socioeconomic and prostate characteristics, as well as technical skills, influence therapy choice. Currently, established techniques worldwide still confirm endoscopic resection using monopolar energy in pole position, while open surgery (particularly in sub-Saharan Africa) still prevails in the choice of surgeons because it is more accessible, both from a socio-economic standpoint and in the training of the surgical personnel. In this article, we will review the evolution of surgical therapy and current trends in surgical management and how this can be adapted to developing regions in terms of technological advancement and economic implications. Deliberate focus is placed on those contemporary minimally invasive surgical techniques that are emerging as providing strong and reproducible levels of efficacy.