A man in his 60s visited the clinic after taking medication for benign prostatic hyperplasia (BPH) for several years, yet his urinary stream had gradually weakened and the sensation of incomplete bladder emptying had worsened. Medical therapy had reached its limits, and surgical treatment was being considered. However, conventional procedures that remove prostate tissue can involve concerns such as anesthesia, bleeding, and recovery time.
As an alternative, the iTIND (temporarily implanted nitinol device) procedure was considered. iTIND works by placing a nitinol stent inside the prostate for approximately one week to expand the urethra. Because it improves urinary flow without removing prostate tissue, it is gaining attention as an intermediate treatment option between medication and surgery. However, an important point is that the procedure is not as simple as it may appear. Outcomes can vary significantly depending on patient selection, physician experience, and the clinical setting.
One of the most common questions patients ask during consultation is, “What type of anesthesia is used?” Since iTIND is often described as a minimally invasive procedure, patients may assume that simple local anesthesia is sufficient. In reality, local anesthesia alone is often inadequate for pain control. Therefore, spinal or caudal anesthesia is typically required, and structured pain management is important to address discomfort that may persist for several days after the procedure.
In addition, accurate placement of the stent requires imaging equipment such as a C-arm fluoroscopy system. Without proper imaging guidance, the device may be incorrectly positioned, increasing the risk of complications such as urethral injury or bleeding.
iTIND can be an effective treatment option for BPH when patients are carefully selected. However, it is not suitable for all patients. Factors such as prostate size, International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), and the presence of bladder neck obstruction must be evaluated comprehensively. This selection process is typically more precise in centers with extensive clinical experience.
Although the procedure itself does not take long, immediate return to daily activities is not always recommended. A short observation period—ranging from several hours to one day—is often advised, depending on the patient’s condition. During this time, pain levels and urinary function should be monitored. Therefore, undergoing the procedure at a facility with appropriate inpatient care and postoperative management systems can contribute to a safer recovery.
The patient described above ultimately chose the iTIND procedure after thorough consultation. Although he experienced some discomfort for a few days after the procedure, structured pain management and close monitoring allowed for a smooth recovery. His urinary flow improved significantly, and he expressed high satisfaction with the outcome.
iTIND represents a meaningful addition to the treatment options for patients with BPH. However, the most important factor is not the procedure itself, but where it is performed. Safe and satisfactory outcomes depend on multiple elements, including appropriate anesthesia and pain management, accurate imaging equipment, careful patient selection, structured postoperative care, and the experience of the medical team.
For patients, the key is not only access to new technology, but access to a medical team that can apply that technology appropriately and effectively.