<p><strong>Clinicians may offer TUIP as an option for patients with prostates <30 cc and without a median lobe for the treatment of LUTS/BPH. (<em>Clinical Principle</em>)</strong></p>
Discussion
Discussion
<p>TUIP has been described for treatment of small prostates <30 cc involving longitudinal incision of the prostate without resection of any tissue. There have been multiple different techniques described for this procedure including single versus multiple incisions of the prostate as well as deep versus shallow incisions. There have also been numerous technologies utilized in this procedure including athermal techniques, electrocautery, and numerous laser technologies.<sup>279, 280</sup> There has been no data favoring one technique over another. </p>
<p>Multiple meta-analyses and retrospective studies of TUIP have shown a significant and durable improvement in IPSS and quality of life scores as well as in Q<sub>max </sub>and PVR out to 24 months.<sup>279, 281, 282</sup> An RCT of 100 men with prostates <30 cc randomized to TUIP versus TURP, showed durable improvement in Q<sub>max</sub> at 24 months in the TUIP group with continued improvement in daytime and nighttime urinary frequency.<sup>283</sup> Notably, in this trial there was a greater improvement in Q<sub>max</sub> occurring in the TURP group.</p>
<p>Regarding morbidity, this is a well-tolerated procedure with a significantly lower risk of blood transfusion with 0.4% TUIP patients requiring a transfusion compared to 8.6% TURP patients. Additionally, retrograde ejaculation favored TUIP (18.2% versus 65.4%).<sup>284 </sup>Unfortunately, long-term data following TUIP is limited therefore it is unclear how durable this procedure is.</p>