New Injection Treatment for Enlarged Prostate: Safety, Efficacy, and Considerations

According to magazine reports: Benign prostatic hyperplasia (BPH) has a newly introduced injection-based curative method that is safe and convenient. What is the evidence for its effectiveness?

According to magazine reports: Benign prostatic hyperplasia (BPH) has a newly introduced injectable curative method.
The prostate is necrotized due to alcohol dehydration, and blood in the urine is expelled, relieving the pressure on the urethra and allowing normal urination to resume.
This method is much safer and more convenient compared to complications such as anesthesia, bleeding, and perforation associated with surgery or transurethral resection.
The only issue is that patients may require a minor scraping afterward.
In urology clinics that have adopted this injection technique, patients must bear the treatment costs themselves.

I would like to inquire about the prognosis of this new injection technique and any related precautions.
Are there any public hospitals or other regional hospitals that have introduced this technology? Why is this injection treatment currently not covered by health insurance? Is it because the technique has not been confirmed through human trials? What is the percentage of patients who require a minor scraping afterward? How does this technique compare to semiconductor laser treatment in terms of advantages and disadvantages? Which method has better efficacy and longer-lasting symptom improvement? Among traditional surgery, electrosurgery, laser treatments, and other transurethral resection methods, which surgical approach is considered safer and more effective? What are the limitations regarding health insurance coverage? Thank you for your response!

Guo, 60~69 year old female. Ask Date: 2004/10/01

Dr. Cai Bingkun reply Urology

Alcohol injection therapy for benign prostatic hyperplasia (BPH) has been adopted by some hospitals, but it has not been implemented in major medical centers in the country.
The introduction of a new technique typically requires clinical trials conducted by large teaching hospitals, and it takes time to establish its efficacy and safety before publication.
This is similar to the previous balloon dilation method, which is now considered to have limited effectiveness.
Furthermore, alcohol injection therapy is akin to the earlier cryotherapy, where postoperative catheterization tends to be longer than in previous surgical methods.
In one case encountered, the catheter was retained for as long as three weeks.
Therefore, it is advisable to wait a period of time before determining its therapeutic efficacy.

Reply Date: 2004/10/01

More Info

The new injection treatment for benign prostatic hyperplasia (BPH), which involves the use of alcohol to induce necrosis of prostate tissue, has garnered attention for its potential benefits over traditional surgical methods. This treatment aims to alleviate urinary obstruction caused by an enlarged prostate, thereby restoring normal urination. However, several considerations regarding its efficacy, safety, and insurance coverage must be addressed.

Efficacy and Prognosis
The primary goal of this injection therapy is to reduce the size of the prostate and relieve symptoms associated with BPH. While initial reports suggest that the treatment can be effective, comprehensive clinical trials are necessary to establish its long-term efficacy and safety profile. The prognosis for patients undergoing this treatment may vary based on individual health conditions and the extent of prostate enlargement.

Safety and Considerations
Compared to traditional surgical options like transurethral resection of the prostate (TURP), the injection method is touted as less invasive, potentially reducing the risks of complications such as bleeding, perforation, and the need for general anesthesia. However, patients may experience side effects, including urinary retention, infection, or the need for additional procedures, such as curettage, to remove necrotic tissue. The percentage of patients requiring this follow-up procedure is still under investigation, but anecdotal evidence suggests it may not be negligible.

Availability and Insurance Coverage
Currently, this injection technique has not been widely adopted in major medical centers, as it requires rigorous clinical validation before becoming a standard treatment option. The lack of insurance coverage for this procedure may stem from its experimental status, as it has not yet undergone extensive human trials to confirm its safety and efficacy. Insurance providers typically require robust clinical evidence before approving coverage for new treatments.

Comparison with Other Treatments
When comparing this injection method to other treatments, such as laser therapy or traditional surgical approaches, several factors must be considered:
1. Efficacy: Laser treatments, like holmium laser enucleation of the prostate (HoLEP), have demonstrated significant efficacy in reducing prostate size and improving urinary symptoms. The long-term results of laser treatments are generally favorable, with many patients experiencing sustained symptom relief.

2. Safety: While the injection method may present fewer immediate risks than surgery, the potential for complications and the need for follow-up procedures must be weighed against the established safety profiles of laser and surgical options.

3. Duration of Symptom Relief: Traditional surgical methods often provide more durable results compared to newer injection therapies, which may require repeat treatments over time.

Conclusion
In summary, while the new injection treatment for BPH presents a promising alternative to traditional surgical methods, further research is essential to validate its safety and efficacy. Patients considering this treatment should discuss it thoroughly with their healthcare providers, weighing the potential benefits against the risks and uncertainties. Additionally, as the medical community continues to evaluate this technique, its acceptance and integration into standard practice will depend on the outcomes of ongoing clinical trials and the establishment of a solid evidence base.

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