If one suffers from symptoms such as frequent urination, sudden and uncontrollable urges to urinate, or needing to urinate during sleep at night, benign prostatic hyperplasia (BPH) can be suspected. In reality, many patients visit hospitals due to BPH, which causes voiding dysfunction. Many of these patients tend to feel burdened by surgery. Concerns about whether they will have to take medication for life after surgery, whether their return to daily life will be delayed, and worries about whether the surgery will affect sexual function are common.
Consequently, recently, procedures that can improve voiding symptoms without excising prostate tissue have been introduced, diversifying the available options. One of these is 'iTind'.
iTind is a 'temporary nitinol stent insertion procedure' where a slender device is inserted into the prostatic urethra to widen the urethral passage. The inserted device is made of a shape-memory alloy (nitinol) and expands by itself at the bladder neck. While maintained in this state for about 5 days, it gently pushes aside the prostate tissue. By applying constant pressure, it induces changes in the urethral structure, allowing the widened passage to be maintained even after the device is removed. Crucially, it offers the prospect of long-term effects through temporary insertion alone, without surgical incision.
The iTind procedure time is relatively short, around 5 minutes. However, for anesthesia, since the device must be inserted via a rigid endoscope, spinal anesthesia or caudal anesthesia is often used in combination.
The iTind procedure is sometimes compared to UroLift, an existing prostatic hyperplasia ligation procedure. Ligation procedures secure the urethra by pulling prostate tissue left and right, leaving a permanent fixation device (stent) within the tissue. In contrast, iTind involves removing the device after the procedure, so no foreign material remains in the body. In this regard, iTind may be more suitable for patients who are sensitive to the sensation of a foreign body or who feel burdened by long-term management.
However, iTind is a procedure approved only for patients who meet specific conditions. According to the standards of the Ministry of Food and Drug Safety (MFDS), it can be applied to patients aged 50 years or older, patients with a prostate size between 25g and 75g (inclusive), patients with an International Prostate Symptom Score (IPSS) of 10 points or higher, and patients with a maximum urinary flow rate (Qmax) of 12 mL/s or less. In other words, patients with an excessively large prostate or mild symptoms are not eligible.
From the perspective of preserving sexual function, iTind is also a significant treatment method. While retrograde ejaculation occurs at a certain rate with conventional surgical methods, such side effects have rarely been 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 eligibility must precede the procedure. Furthermore, the judgment of experienced and skilled medical professionals is crucial.
Dr. Ryu Kyung-ho, director of Goldman Urology Clinic Gangnam Branch, stated, “While the iTind procedure itself may seem simple, to maximize its effectiveness, a combination of factors such as patient selection and equipment utilization must be harmonized.” He added, “Treatment for benign prostatic hyperplasia directly impacts a patient's quality of life. Many people postpone treatment, thinking their symptoms are still tolerable, but if discomfort recurs, it is advisable to consider less burdensome treatment options first.”