You have accessJournal of UrologyHistory of Urology Forum II (HF02)1 Sep 2021HF02-07 IN TURP-ETUITY? HISTORICAL TREATMENTS FOR BPH AND CONSIDERATION OF THEIR MODERN-DAY ANALOGUES Dylan Buller, and Keith O'Brien Dylan BullerDylan Buller More articles by this author , and Keith O'BrienKeith O'Brien More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001993.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The enlarged prostate has long been a target of surgical intervention. While procedures such as simple prostatectomy and transurethral resection of the prostate have found durability over the past hundred years, attempts at novel approaches to treat benign prostatic hyperplasia (BPH) have been trialed for centuries. Similarities can be found between abandoned historical methods and modern-day interventions. METHODS: Primary and secondary sources of both historical and modern-day procedures for BPH surgery were reviewed. RESULTS: Obstructive urinary symptoms in the aging male have been recognized for millennia. In 1575, Paré’s transurethral punch device was employed to remove obstructing urethral tissue. Remarkably, this was 75 years before Jean Riolan the Younger identified the prostate as the culprit in urinary obstruction. Although largely forgotten over the next 300 years, the prostatic punch re-emerged at the hands of famed urologic pioneer Hugh Hampton Young in 1909. In the early 1800s, Syng devised a sound that included an inflatable bag at its tip; upon insertion, the bag was inflated in an attempt to dilate the prostatic urethra. This procedure was abandoned due to poor patient tolerability and lack of effect–that is, until the introduction and subsequent abandonment of ‘transurethral balloon dilation of the prostate’ at the end of the 20th century. The ‘transurethral implantable nitinol device,’ a newly introduced procedure, is predicated on similar foundational concepts. In the 1890s, Bier and Meyer reported on bilateral internal iliac artery ligation as a method for shrinking the enlarged prostate. Alas, Meyer’s first attempt necessitated extensive small bowel resection, and his patient ultimately died. Indeed, advocates of prostate artery embolization, which emerged at the turn of the 21st century, may feel heartened by the minimally invasive access employed by this modern analogue. Fortunately, not all historical techniques have been revisited. White introduced orchiectomy for BPH in 1893, and in 1896, Cabot reported that 84% of castrated BPH patients experienced symptomatic improvement. Literature was also published on the successful treatment of BPH with vasectomy; this, too, was abandoned in the early 1900s. CONCLUSIONS: Interventions to relieve urinary obstruction caused by the enlarged prostate have made great advancements in efficacy and safety. Nonetheless, many modern techniques have foundations in historical practices. Early reports of success do not necessarily confer durability of effects or longstanding usage in practice. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e239-e239 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Dylan Buller More articles by this author Keith O'Brien More articles by this author Expand All Advertisement Loading ...
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