Many patients with benign prostatic hyperplasia (BPH) find themselves caught between ongoing medication and the fear of surgery. Medications may not provide sufficient relief, yet surgery raises concerns about side effects, particularly sexual function. Questions such as “Do I have to take medication for life?” or “Will surgery affect ejaculation?” are common. Recently, minimally invasive treatment options that improve urinary symptoms without removing prostate tissue have expanded patient choices. One such option is iTind.
iTind (temporarily implanted nitinol device) is a minimally invasive procedure designed to reshape the prostatic urethra without cutting or removing tissue. A thin device made of nitinol, a shape-memory alloy, is inserted into the prostatic urethra. Once positioned near the bladder neck, the device expands and applies gentle, continuous pressure to the surrounding prostate tissue. It remains in place for approximately five days, gradually remodeling the urethral channel. After removal, the widened urethral passage is maintained, allowing for improved urine flow without permanent implants or tissue removal.
The procedure itself is relatively quick, typically taking around five minutes. However, because insertion is performed using a rigid cystoscope, local anesthesia alone may not be sufficient for pain control. Sedation or regional anesthesia is often used to ensure patient comfort. In some clinical settings, real-time imaging such as C-arm fluoroscopy is used to confirm accurate device placement before and after insertion, enhancing procedural precision and safety.
iTind is often compared with the prostatic urethral lift (UroLift). UroLift works by permanently placing implants that retract prostate tissue and keep the urethra open. In contrast, iTind does not leave any foreign material in the body after the device is removed. This can be advantageous for patients who are sensitive to implanted devices or prefer to avoid long-term foreign bodies.
Patient selection is critical for iTind. According to regulatory guidelines, candidates should typically be over 50 years of age, have a prostate volume between 25 g and 75 g, an International Prostate Symptom Score (IPSS) of 10 or higher, and a maximum urinary flow rate (Qmax) of 12 mL/s or less. Patients with very large prostates or only mild symptoms may not be suitable candidates.
Clinical outcomes have been encouraging. Studies comparing pre- and post-procedure results show approximately a 50% reduction in IPSS and nearly a doubling of Qmax. In some patients, structural changes resembling three-point expansion of the bladder neck region (at positions corresponding to 12, 5, and 7 o’clock) have been observed, contributing to improved urinary flow. The procedure appears particularly effective in patients with a relatively narrow bladder neck, where even mild prostate enlargement can significantly impair urination.
Preservation of sexual function is another key advantage. Unlike traditional surgical methods, which may carry a risk of retrograde ejaculation, iTind has shown a very low incidence of such side effects. This makes it an attractive option for sexually active men, particularly those in their 50s and 60s who are concerned about maintaining ejaculatory function.
However, iTind is not suitable for all cases. Patients with significant median lobe enlargement or marked intravesical protrusion of the prostate may experience limited benefit. Careful evaluation and appropriate patient selection are essential. Although the procedure itself is relatively simple, achieving optimal outcomes requires clinical expertise, precise technique, and proper use of imaging and equipment.
BPH management directly impacts quality of life. Many patients delay treatment because symptoms seem tolerable, but persistent discomfort should not be ignored. Minimally invasive options like iTind offer a balance between effectiveness and reduced treatment burden, with the added benefit of preserving sexual function and allowing for rapid return to daily activities. As clinical experience grows, iTind is expected to become an increasingly valuable option in personalized BPH treatment strategies.