Treatment of BPH – iTind
Overview by Mr Gordon Muir
Consultant Urological Surgeon
Kings College Hospital NHS Trust
The iTIND treatment for enlarged prostate is a new device which looks a little like the cage on a champagne cork and which is placed into the prostate under local anaesthetic. Essentially it has three small spring bars on it which apply gentle pressure onto the inside of the prostate over a week – it is then removed under local anaesthetic.
The end result is that three small incisions (a bit like a Mercedes Benz badge when seen through the telescope) are made in the prostate and this allows symptom relief in the first year, not dissimilar to that seen with bladder neck incision or TURP.
No cases of sexual function or dry orgasm have been reported with the iTIND so far although its use has been limited to moderately enlarged prostates and data with much larger prostates is limited.
Trials are currently running in looking at the iTIND in men with retention of urine. The long-term revision rate of the iTIND isn’t known as it is new but the short-term re-operation rate would seem to be in the order of 3-5% per annum.
Ongoing studies are looking at its place in bigger prostates and men in urinary retention. At present it can be recommended to men with smaller prostates without a middle lobe.
ITIND is a simple device to implant –most centres place it under a short general anaesthetic but we usually insert it in the outpatients department under local anaesthetic. After placing the device it is left sitting in the prostate for about a week before removal – some men find this an uncomfortable period but the irritative symptoms usually disappear within a day or two of the device being removed.
Flow rates and improvements in the IPSS score are shown below and are equivalent to those seen with bladder neck incision. So far no man has reported any sexual dysfunction with the device, making it an attractive option for men wishing to preserve ejaculation.
The following graphs show the performance of The iTIND treatment for enlarged prostate.
Image taken from the Medi-Tate site.
iTIND is not available in New Zealand at present.
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