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How to treat
enlarged prostate
with Boston Scientific 

Enlarged prostate treatment options

In some cases, minimally invasive procedures are appropriate choices, and sometimes a combination of treatments work. 

Treatment options

Types of treatment include active surveillance, prescription medication, minimally invasive procedures and more invasive procedures.1

Open prostate removal surgery, or open prostatectomy, is a type of procedure that requires a large incision to be made in the lower part of the abdomen.2

There are many different types of surgical procedures like transurethral resection of the prostate (TURP), Aquablation (a novel, minimally invasive, water-based therapy) or Laser Therapies for benign prostate enlargement (BPE).3 Although surgery works well for most men, it can cause side effects.2 Access to the prostate is obtained through the urethra rather than the abdomen.2,3

Less invasive procedures, such as Water Vapour Therapy, prostatic urethral lift, and temporarily implanted nitinol device are minimally invasive, which can result in fewer side effects that impact life following treatment, e.g. sexual function (versus standard surgical procedures).4,5 

You are part of the decision making about how to treat your enlarged prostate

Our solutions use two types of technology for an enlarged prostate – Water Vapour (or steam) Therapy and Laser Therapy. They have been designed to be chosen based on the patients´ prostate anatomy, comorbidities and procedural preferences.6,7

Proven treatments for peace of mind

Boston Scientific’s enlarged prostate treatments* are tailored to your individual needs, leading to sustained quality of life improvements for at least five years.8-10

 – According to studies, the reoperation rate for Water Vapour Therapy was 4.4% and 4.8% for Photovaporization of the prostate Laser Therapy at five years. 9,11

 – Enlarged prostate symptoms (IPSS, Qmax, etc.) were reduced significantly following treatment and the improvements were maintained for at least five years.9,10,12-14

 – Water Vapour and Laser Therapies are transurethral procedures which may result in a low rate of postoperative complications. 9,11,13,15

*When discussing the Boston Scientific benign prostatic hyperplasia (BPH) treatment options, claims apply to one or more products that could meet the needs of the patient and/or provider. Refer to associated references for applicable products.

Our Water Vapour and Laser Therapies have complementary capabilities, allowing you and your urologist to make a choice that works for you
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Did you know?

Following Water Vapour Therapy, 91% of patients were satisfied with outcomes, 94% were satisfied overall, and 97% would recommend to a friend.16 And patients who received PVP Laser Therapy, report 94% satisfaction at 12 months and 88% mostly satisfaction at mean 57 months.11,17 

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Clinical evidence

Both our Laser and Water Vapour Treatment options are supported by clinical data and included in one or more of the following guidelines or guidance: EAU, NICE, DGU or AUA 6,7,18,19

References

1.Urology Care Foundation. Benign prostatic hyperplasia (BPH). September 2023. Available at: https://www.urologyhealth.org/urology-a-z/b/benign-prostatic-hyperplasia-(bph). [Accessed September 2023].

2.EAU Patient Information. Open prostatectomy. September 2023. Available at: https://patients.uroweb.org/treatments/open-prostatectomy. [Accessed September 2023].

3.Hwang EC, Jung JH, Borofsky M et al. Aquablation of the prostate for the treatment of lower urinary tract symptoms in men with benign prostatic hyperplasia. Cochrane Database Syst Rev. 2019;2019(2):CD013143.

4.Rijo E, Hindley R, Tabatabaei S, et al. Minimally invasive surgery for benign prostatic obstruction: new insights and future technical standards. Curr Opin Urol. 2021;31(5):461–467.

5.Taktak S, et al. Aquablation: a novel and minimally invasive surgery for benign prostate enlargement. Ther Adv Urol. 2018;10(6):183–188

6.Lerner LB, McVary KT, Barry MJ, et al. Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA Guideline Part II—surgical evaluation and treatment. J Urol. 2021;206(4):818–826.

7.Gravas S, Cornu JN, Gacci M, et al. EAU guidelines on management of non-neurogenic male LUTS. March 2023. Available at: https://uroweb.org/guidelines/management-of-non-neurogenic-male-luts. [Accessed September 2023].

8.Ajib K, Mansour M, Zanaty M, et al. Photoselective vaporization of the prostate with the 180-W XPS-Greenlight laser: five-year experience of safety, efficiency, and functional outcomes. Can Urol Assoc J. 2018;12(7):E318–E324.

9.McVary KT, Gittelman MC, Goldberg KA, et al. Final 5-year outcomes of the multicenter randomized sham-controlled trial of a water vapor thermal therapy for treatment of moderate to severe lower urinary tract symptoms secondary to benign prostatic hyperplasia. J Urol. 2021;206(3):715–724.

10.Elmansy HM, Kotb A, Elhilali MM. Holmium laser enucleation of the prostate: long‐term durability of clinical outcomes and complication rates during 10 years of followup. J Urol. 2011;186(5):1972–1976.

11.Calves J, Thoulouzan M, Perrouin-Verbe MA, et al. Long-term patient-reported clinical outcomes and reoperation rate after photovaporization with the XPS-180W greenlight laser. Eur Urol Focus. 2019;5(4):676–680.

12.Law KW, Tholomier C, Nguyen DD, et al. Global Greenlight Group: largest international Greenlight experience for benign prostatic hyperplasia to assess efficacy and safety. World J Urol. 2021;39(12):4389-4395. doi:10.1007/s00345-021-03688-4

13.Sun I, Yoo S, Park J, et al. Quality of life after photo-selective vaporization and holmium-laser enucleation of the prostate: 5-year outcomes. Sci Rep. 2019;9(1):8261.

14.Woolin T, Denstedt J. The holmium laser in urology. J Clin Laser Med Surg. 2009;16(1):13–20

15.Thomas JA, Tubaro A, Barber N, et al. A Multicenter Randomized Noninferiority Trial Comparing GreenLight-XPS Laser Vaporization of the Prostate and Transurethral Resection of the Prostate for the Treatment of Benign Prostatic Obstruction: Two-yr Outcomes of the GOLIATH Study. Eur Urol. 2016;69(1):94-102. doi:10.1016/j.eururo.2015.07.054

16.Mooney R, Goldberg K, Wong D, et al. Convective radio frequency thermal therapy for treatment of benign prostatic hyperplasia: single office experience with 255 patients over 4 years. Urol Pract. 2020;7(1):28–33.

17.Bachmann A, et al. A European multicenter randomized noninferiority trial comparing 180 W GreenLight XPS laser vaporization and transurethral resection of the prostate for the treatment of benign prostatic obstruction: 12-month results of the GOLIATH study. J Urol. 2015;193(2):570–578.

18.NICE. Rezum for treating lower urinary tract symptoms secondary to benign prostatic hyperplasia. [Medical technologies guidance 49]. 24 June 2020. Available at: https://www.nice.org.uk/guidance/mtg49. [Accessed September 2023].

19.AWMF Online. Leitlinie Diagnostik und Therapie des Benignen Prostatasyndroms (BPS). Available at: https://register.awmf.org/de/leitlinien/detail/043-034 [Accessed September 2023].

The Rezūm System is intended to relieve symptoms, obstructions, and reduce prostate tissue associated with benign prostatic hyperplasia (BPH). It is indicated for men with a prostate volume 30cm3. The Rezūm System is also indicated for treatment of prostate with hyperplasia of the central zone and/or a median lobe.  Potential risks associated with Rezūm Water Vapor Therapy include but are not limited to dysuria, hematuria, hematospermia, decrease in ejaculatory volume, suspected urinary tract infection (UTI), urinary frequency, and retention or urgency.

The GreenLight™ laser system is intended for incision/excision, vaporization, ablation, hemostasis, and coagulation of soft tissue, including photoselective vaporization of the prostate for benign prostatic hyperplasia (BPH). The laser system is contraindicated for patients who: are contraindicated for surgery, contraindicated where appropriate anesthesia is contraindicated by patient history, have calcified tissue, require hemostasis in >2mm vessels, have uncontrolled bleeding disorders, have prostate cancer, have acute urinary tract infection (UTI), or severe urethral stricture. Possible risks and complications include, but are not limited to, irritative symptoms (dysuria, urgency, frequency), retrograde ejaculation, urinary incontinence, erectile dysfunction, hematuria - gross, UTI, bladder neck contracture/outlet obstruct, urinary retention, perforation - prostate, urethral stricture.

The Lumenis Pulse 120H System  is intended to relieve symptoms and obstructions and reduce prostate tissue associated with BPH  It is contraindicated for patients who are unable to receive endoscopic treatments or are intolerant to prolonged anesthesia, as well as for resection or excision of large vascularized organs.  Holmium lasers are intended solely for use by physicians trained in the use of the Ho:YAG (2.1 μm) wavelength.  Incorrect treatment settings can cause serious tissue damage.  The laser should be used only on tissues that are fully observable.  Possible risks and complications include, but are not limited to, irritative symptoms (dysuria, urgency, frequency), retrograde ejaculation, urinary incontinence, erectile dysfunction, hematuria - gross, UTI, bladder neck contracture/outlet obstruct, urinary retention, perforation - prostate, urethral stricture. You should talk with your doctor about benefits and risks before moving forward with any treatment option.

Boston Scientific acquired the global surgical business of Lumenis Ltd. Some registered names of products Boston Scientific acquired the global surgical business of Lumenis Ltd. Some registered names of products manufactured and sold by Boston Scientific may contain the term “Lumenis”. Lumenis is a registered trademark of Lumenis Be.MyProstateInfo.co.uk is a website sponsored by Boston Scientific.

This material is for informational purposes only and not meant for medical diagnosis. This information does not constitute medical or legal advice, and Boston Scientific makes no representation regarding the medical benefits included in this information. Boston Scientific strongly recommends that you consult with your physician on all matters pertaining to your health.

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