Benign prostatic hyperplasia (BPH) is a common urologic condition among older men. It occurs when prostate tissue enlarges abnormally and compresses the urethra, leading to urinary difficulties. Common symptoms include frequent urination, nighttime urination, a feeling of incomplete bladder emptying, and urinary urgency. These symptoms can significantly reduce quality of life if left untreated.
Traditionally, treatment for BPH has included medication and surgical procedures such as transurethral resection of the prostate (TURP). However, newer treatment options that reduce surgical burden have recently emerged, including a procedure known as iTind.
Conventional TURP involves inserting an endoscope through the urethra to remove enlarged prostate tissue. Although effective, it usually requires general or spinal anesthesia and carries potential risks such as bleeding, infection, urethral stricture, urinary incontinence, and retrograde ejaculation. In addition, patients often require several days of hospitalization and postoperative catheterization. For older patients or those with underlying medical conditions, this can be a significant burden.
In contrast, the iTind procedure does not remove prostate tissue. Instead, a temporary device made of nitinol, a shape-memory alloy, is inserted into the urethra to gently expand the prostatic urethra. The device gradually opens in response to body temperature, widening the urinary passage and improving urine flow. It is typically removed after five to seven days. Because the procedure does not involve tissue removal, the risks of bleeding, infection, and anesthesia-related complications are minimal. The procedure itself usually takes around 20 minutes, and most patients can return home the same day.
Another advantage of iTind is that it can be performed under local anesthesia without general anesthesia. Recovery is typically rapid, and in many cases, catheterization is not required. Importantly, sexual and ejaculatory functions are generally preserved after the procedure.
Clinical data also support the effectiveness of iTind. In studies, the International Prostate Symptom Score (IPSS) improved from an average of 22.5 before treatment to 11.3 after treatment, representing roughly a 50 percent reduction in symptom severity. Urinary flow rate also increased from 7.3 ml/s to 15.2 ml/s, nearly doubling after treatment. Additionally, sexual and ejaculatory functions were preserved without significant changes, and the reoperation rate within three years was reported to be about 4 percent.
However, iTind is not suitable for every patient. Its effectiveness depends on factors such as prostate size, urethral anatomy, bladder function, and the severity of obstruction. Therefore, thorough evaluation is necessary before the procedure, including prostate ultrasound, uroflowmetry, post-void residual measurement, and cystoscopy. In patients who have had long-standing BPH leading to bladder dysfunction, more definitive procedures such as resection surgery may still be the better option.
Dr. Na Jun-chae of Goldman Urology Clinic’s Jamsil branch explained that the key difference between conventional surgery and iTind lies in invasiveness and patient burden. While traditional surgery represents a more intensive treatment approach, iTind offers a safer and less invasive alternative for improving urinary symptoms associated with BPH. He added that for elderly patients or those who are hesitant about undergoing surgery, iTind can be a practical treatment option.