If you find yourself urinating more frequently with age, experiencing a weak stream, or waking up multiple times at night to urinate, it may not simply be a normal part of aging. These symptoms could indicate benign prostatic hyperplasia (BPH).
As the prostate enlarges, it can compress the urethra and interfere with normal urination. This condition affects more than half of men over the age of 60. If left untreated, it may lead to complications such as decreased bladder function, bladder stones, urinary tract infections, and even kidney damage.
In the early stages of BPH, symptoms can often be managed with medication. However, over time the medication may become less effective, side effects may develop, or symptoms may worsen. In such cases, surgical treatment may be necessary. Importantly, this does not always mean undergoing a major surgery. Recently, minimally invasive surgical treatments (MIST) that place less strain on the body and allow faster recovery have gained increasing attention. Below is a question-and-answer overview of some of the treatment options that patients frequently ask about.
What is MIST?
MIST stands for minimally invasive surgical treatment. Compared with traditional surgery, it aims to minimize physical trauma to the body. Most procedures can be performed under local anesthesia or mild sedation without general anesthesia. Hospitalization is often unnecessary or very short, and recovery tends to be quick. Because the impact on daily life is minimal, MIST procedures are particularly useful for working individuals and elderly patients.
What are the main types of MIST treatments?
1. Water Vapor Thermal Therapy (Rezum)
This treatment injects high-temperature water vapor into prostate tissue, causing the enlarged tissue to undergo necrosis and gradually shrink. The procedure can typically be performed under local anesthesia, takes less than 10 minutes, and allows relatively quick recovery. It also has a high rate of preservation of sexual function. Many hospitals in Korea already perform this procedure, and both its safety and effectiveness have been well documented.
2. Prostatic Urethral Lift (UroLift)
This method does not remove prostate tissue. Instead, special implants are used to pull the enlarged prostate lobes aside, widening the prostatic urethra. The procedure is performed without incisions and generally preserves sexual function, making it a good option for patients who are particularly concerned about issues such as retrograde ejaculation.
3. Temporary Implanted Nitinol Device (iTind)
This minimally invasive treatment uses a temporary nitinol device to widen the narrowed prostatic urethra. The device remains in place for about five to seven days and is then removed. Even after removal, the urethral channel remains widened, allowing improved urine flow. Although this is a relatively new technique, early clinical results have been promising and its use may become more widespread in the future.
How does MIST differ from traditional surgery?
The most well-known traditional surgical procedure is transurethral resection of the prostate (TURP). While TURP has long proven effectiveness, it may involve risks such as bleeding, infection, and retrograde ejaculation, and typically requires hospitalization and general anesthesia. In contrast, most MIST procedures can be performed in an outpatient setting, involve faster recovery, and have significantly lower rates of sexual side effects.
Who is a suitable candidate for MIST?
MIST treatments are not appropriate for every patient with BPH. Factors such as prostate size, prostate shape, and the severity of symptoms must be carefully evaluated by a urology specialist. For example, patients with very large prostates, significant middle lobe enlargement, or already developed bladder dysfunction may be better suited to conventional surgical approaches. In practice, UroLift is generally not recommended when the middle lobe is significantly enlarged, and Rezum may not provide sufficient results for extremely large prostates. Proper patient selection is therefore essential.
Conclusion: Consultation comes before choosing a treatment
BPH is not a condition that should simply be tolerated or ignored. If left untreated, it can reduce quality of life and lead to more serious health problems. Fortunately, a variety of treatment options are now available, allowing patients to choose a therapy that best suits their individual condition. If you experience symptoms such as weak urine flow or frequent urination, it is advisable to consult a urologist before the condition progresses. With early diagnosis and appropriate treatment, it is possible to maintain a good quality of life.