A significant number of patients seeking medical attention for benign prostatic hyperplasia (BPH) can be seen as cases who have relied on drug therapy. However, they often find themselves troubled because their daily discomfort is not resolved. The problem is that surgical operations are burdensome, making it difficult for them to make a decision easily. This is because there are significant concerns about whether they might have to take medication for life, or if there will be changes in sexual function after surgery.
Recently, minimally invasive treatment methods have emerged to alleviate these concerns, broadening the range of options available. Among them, 'iTind' is gaining attention; it's a procedure that improves urinary symptoms with a treatment lasting approximately 5 minutes, without any incision.
iTind is also known as 'temporary nitinol stent insertion,' a method that involves inserting a slender device into the prostatic urethra to widen the urethral passage. The device is made of a shape-memory alloy (nitinol), which self-expands at the bladder neck and remains in place for approximately 5 days. During this period, a constant pressure gently pushes aside the prostatic tissue and induces structural changes in the urethra, which is its key characteristic. Furthermore, the principle is that the widened urethral space is maintained even after the device is removed. Since there is no incision and no permanent stent left behind, there is less foreign body sensation or burden of long-term management.
Although the procedure time is very short, around 5 minutes, an endoscope is required for device insertion, so spinal anesthesia or caudal anesthesia is typically performed concurrently. This is because simple local anesthesia alone has limitations in pain control. Some hospitals are enhancing the safety and effectiveness of the procedure by utilizing C-arm real-time fluoroscopy equipment to precisely confirm the device's position. This is crucial because, despite being minimally invasive, accurate positioning dictates the success of the treatment.
iTind is sometimes compared to the existing prostatic urethral lift procedure, 'UroLift'. UroLift secures the urethra by pulling the prostatic tissue left and right, leaving permanent fixation devices within the body. In contrast, with iTind, nothing remains in the body once the device is removed after 5 days. Due to this aspect, it is highly preferred among patients who are sensitive to foreign body sensations or who find the presence of metal in their body itself uncomfortable.
Most notably, sexual function preservation is a key highlight. While retrograde ejaculation occurs in a certain percentage of traditional resection procedures, such side effects have been rarely reported with iTind. As a result, inquiries about the procedure are rapidly increasing among patients in their 50s and 60s who are sensitive to changes in sexual function.
However, not all patients are candidates for the iTind procedure. The procedure can only be applied to individuals who are 50 years of age or older, have a prostate size between 25-75g, an IPSS score of 10 points or higher, and a maximum urinary flow rate (Qmax) of 12mL/s or less. Accurate prior evaluation is essential because the effectiveness decreases if symptoms are too mild or, conversely, if the prostate is excessively large.
Furthermore, if there is severe median lobe protrusion or if the prostate is deeply enlarged towards the bladder, the effectiveness of the procedure may be limited. Additionally, temporary discomfort or a feeling of stiffness during urination may occur while the device remains in the body, and an explanation regarding this is also necessary.
Dr. Kim Tae-heon, director of Goldman Urology Seoul Station branch, stated, "Benign prostatic hyperplasia is a disease that significantly reduces the quality of life, yet many patients often postpone treatment, saying they can still bear it." He added, "When drug therapy feels limited, when incisions are burdensome, or when worrying about sexual function side effects, iTind can be a realistic alternative that is minimally invasive and allows for rapid recovery."