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Traitement de l'hyperplasie bénigne de la prostate pour les hommes canadiens

MIST

Minimally invasive surgical therapies (MIST) for benign prostatic hyperplasia (BPH) are procedures that can be done without general anesthesia or a hospital stay.

Minimally Invasive Surgical Therapies

These minimally invasive procedures have minimal downtime, are outpatient procedures, and do not always require patients to wear a catheter post-procedure. Patients who undergo these treatments are able to return to their daily activities within a few days after the procedure. They relieve patients of BPH symptoms without the use of medications or permanent implants, and allow patients to experience symptom relief within two weeks.

There are three common MIST treatments that treat symptoms of BPH safely and effectively: Rezum, iTind, and UroLift.

Minimally Invasive Surgical Therapy Benefits

The main difference between MIST treatments and other BPH treatments is that they are minimally invasive with minimal downtime.

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Treatments

The procedures for each MIST treatment are relatively similar. They all have the ability to be performed without a hospital stay.

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Rezum Water Vapor Therapy

For Rezum Water Vapor Therapy, during each 9-second treatment, sterile water vapor is released throughout the targeted prostate tissue. When the steam contacts the prostate tissue, all the stored energy is released into the tissue. Your doctor will determine the amount of treatments you need, based on the size of your prostate. Over time, your body’s natural healing response absorbs the treated tissue, shrinking the prostate. With the extra tissue removed, the urethra opens, reducing BPH symptoms.

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iTind

For iTind, the device is placed in the prostatic urethra in a folded configuration. During the 5 to 7-day treatment, it slowly expands and exerts gentle pressure at three precise points to widen the opening through which urine flows through the prostatic urethra and then out of the body. After 5 to 7 days, the device is completely removed. Clinical trials demonstrate that the newly remodeled prostatic urethra will continue to provide long-lasting relief of BPH symptoms.
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UroLift

With UroLift, the UroLift Delivery Device is placed through the obstructed urethra to access the enlarged prostate. Then, small UroLift Implants are permanently placed to lift and hold the enlarged prostate tissue out of the way and increase the opening of the urethra. Finally, the UroLift Delivery Device is removed, leaving an open urethra designed to provide symptom relief.
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Zenflow Spring

The Zenflow Spring clinical trial evaluates a new investigational treatment, to relieve symptoms of an enlarged prostate. The permanent Spring Implant is small nitinol implant that is delivered via the urethra using a flexible cystoscope. Once inserted, it keeps the urethra open and prohibits it from becoming too narrow again. This allows the urinary flow rate to return to normal, and provides patients with relief from their symptoms that were caused by an enlarged prostate and narrow urethra.

Optilume MIST BPH Treatment

Optilume

With Optilume, a catheter is inserted into the urethra up to the location of the prostate. Once the catheter is set in place, a cylindrical balloon is inflated to press against the prostate tissue, creating a passageway for urine to flow through. As the balloon expands, it creates micro fissures in the tissue. The coating of the balloon releases a therapeutic medication directly onto the fissured tissue. This medication reduces cell proliferation and fibrotic scar tissue generation, which helps relieve urinary obstruction and improves the flow of urine.

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Contino

With Contino, you self-insert the Contino device into your urethra and remove it prior to urination. It is fairly easy and comfortable to use. The Contino device enables you to control when you urinate, avoiding inconvenient and embarrassing messes. You simply remove the device when you need to urinate and reinsert afterwards. It is easy, comfortable, and convenient. No adult diapers or bags required.

Who is a Candidate?

MIST BHP therapies are generally suited for men that do not want to take medication for BPH symptoms on an ongoing basis and cannot, or do not wish to undergo the risks of a standard surgical intervention.
When satisfactory treatment results can be obtained with a MIST option this is usually preferable to the risks and side effects of surgery or medication.
effective BPH interventions in Canada

Duration

The duration for each MIST treatment varies, but they are overall generally short.

  • While the actual Rezum procedure only takes a couple of minutes, patients typically spend around two hours for the entire appointment due to recovery and observation after the operation.
  • The insertion of the iTind device into the prostatic urethra generally takes a few short hours. Following the initial insertion, it takes 5 to 7 days for the iTind device to widen the prostatic urethra, during which patients may resume their daily activities.
  • Treatment with the UroLift System typically takes less than one hour, and does not preclude future UroLift System treatments, TURP, or laser procedures.

Recovery

The recovery period for MIST treatments is typically short. Patients are able to return to their daily activities within a few days after the procedure, and may not require a catheter to be put in place. Most patients experience symptom relief within two weeks after the procedure.

Risks/Side Effects

The most common risks or side effects associated with MIST treatments include:

  • Painful or frequent urination
  • Blood in the urine
  • Pelvic pain
  • Urinary tract infections (UTIs)
  • Inflammation of the prostate gland
  • Urinary incontinence
Overall, these side effects typically resolve within two to four weeks after the procedure.

Additional BPH Treatments

If you believe that MIST treatments may not be the best option for you, there are other BPH treatments available besides MIST. These include surgical options, such as Turp, GreenLight, HoLEP, and Aquablation. Other options include medication, such as Alpha Blockers, 5-Alpha Reductase Inhibitors, and PDE-5 Inhibitors.

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