Surgical versus minimally invasive therapies for benign prostatic hyperplasia: integrating artificial intelligence for personalized treatment selection
Abstract
Benign prostatic hyperplasia (BPH) is one of the main causes of LUTS in aging men.
Objective. Compare surgical and minimally invasive therapies (TURP, HoLEP, PAE, office MIST) and outline how artificial intelligence (AI) can inform the selection of personalized procedures.
Methods. Analytical review of RCTs, meta-analyses, and guidelines; the results included IPSS, Qmax, QoL, adverse events, sexual function, and retreat <12 months.
Results. Bipolar TURP matches monopolar efficacy with superior safety. HoLEP offers long-lasting relief and fewer reoperations, including large glands. PAE yields meaningful benefit in experienced centers, but generally underperforms TURP in comparative trials. MIST (Rezūm, PUL/UroLift) provides relief from symptoms with preserved ejaculation. AI models that aggregate clinical and instrumental features show promise for personalized decision-making.
Conclusions. TURP/HoLEP remain high-efficacy standards; PAE is viable for selected candidates; MIST is valuable for men prioritizing sexual function and quick recovery. AI may further refine patient stratification and procedural choice.
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