If you suffer from symptoms such as frequent urination, a sudden and unbearable urge to urinate, or needing to urinate while sleeping at night, you might suspect benign prostatic hyperplasia (BPH). In fact, many patients visit hospitals due to BPH, which causes various voiding dysfunctions. Among these patients, many tend to feel burdened by the prospect of surgery. Their worries often revolve around concerns such as whether they will have to take medication for the rest of their lives after surgery, whether their return to daily life will be delayed, or whether the surgery will negatively impact their sexual function.
Accordingly, various procedures that can improve voiding symptoms without resecting prostate tissue have recently been introduced, diversifying the range of available treatment options. Among these, one such option is 'iTind'.
iTind is a 'temporary nitinol stent insertion procedure' that works by inserting a slender device into the prostatic urethra to widen the urethral passage. The inserted device, made of a shape-memory alloy (nitinol), expands by itself at the bladder neck. A key feature is that while maintained in this state for approximately 5 days, it gently pushes aside the prostate tissue. The underlying principle is to induce changes in the urethral structure through constant pressure, thereby maintaining the widened passage even after the device is removed. Most importantly, the core advantage is the expectation of long-term effects through only temporary insertion, without the need for surgical incision.
The iTind procedure time is relatively short, typically around 5 minutes. However, regarding anesthesia, because the device must be inserted via a rigid endoscope, spinal anesthesia and caudal anesthesia are often administered concurrently.
The iTind procedure is sometimes compared to UroLift, an existing prostatic hyperplasia ligation procedure. Ligation procedures secure the urethra by pulling the prostate tissue left and right, leaving a fixed device (stent) within the tissue. In contrast, iTind involves removing the device after the procedure, meaning no foreign material remains in the body. In this respect, iTind may be more suitable for patients who are sensitive to the sensation of a foreign body or who feel burdened by the prospect of long-term management of an implanted device.
However, iTind is a procedure approved only for patients who meet specific conditions. According to the standards set by the Ministry of Food and Drug Safety (MFDS), it can be applied to patients who are 50 years of age or older, those with a prostate size between 25g and 75g (inclusive), patients with an International Prostate Symptom Score (IPSS) of 10 points or higher, and those with a maximum urinary flow rate (Qmax) of 12 mL/s or less, among other criteria. In other words, patients whose prostate is excessively large or whose symptoms are mild cannot be candidates for this procedure.
From the perspective of preserving sexual function, iTind is also a significant treatment method. While existing surgical methods often result in retrograde ejaculation at a certain rate, such side effects have been rarely reported with iTind.
Of course, iTind is not a panacea. If there is severe median lobe protrusion or if the prostate is deeply enlarged into the bladder, the effectiveness of the procedure may be limited. Therefore, an accurate evaluation of the patient's suitability must precede the procedure. Furthermore, the judgment of experienced and skilled medical professionals is crucial.
Director Ryu Kyung-ho of Goldman Urology Gangnam Branch stated, "While the iTind procedure itself may appear simple, maximizing its effectiveness requires a harmonious combination of complex factors, including meticulous patient selection and optimal equipment utilization." He added, "Treatment for benign prostatic hyperplasia is directly linked to a patient's quality of life. Although many individuals with symptoms delay treatment, believing their discomfort is still tolerable, it is advisable to consider less burdensome treatment methods first if the discomfort becomes recurrent."