Minimally Invasive Surgical Therapies for Benign Prostatic Hyperplasia: Current Advances and Future Perspectives

Benign prostatic hyperplasia (BPH) is a highly prevalent urological condition characterized by progressive enlargement of the prostate gland, leading to lower urinary tract symptoms (LUTS) that affect quality of life in aging men. While medical management remains the first-line treatment, many patients eventually require surgical intervention due to refractory symptoms, intolerance to medications, or complications such as urinary retention. Traditional surgical approaches, such as transurethral resection of the prostate (TURP), are effective but associated with significant perioperative risks and functional side effects. In response, minimally invasive surgical therapies (MISTs) have emerged as viable alternatives, offering symptom relief with reduced morbidity, shorter hospital stays, and faster recovery. This review provides a comprehensive analysis of current MIST options, including laser-based therapies, prostatic urethral lift (UroLift), water vapor thermal therapy (Rezum), prostatic artery embolization (PAE), and aquablation. The mechanisms, efficacy, safety, and patient selection criteria for each technique are critically evaluated. Additionally, the review highlights recent technological innovations, long-term outcome data, and future directions for integrating these procedures into personalized BPH management. Keywords: Benign prostatic hyperplasia, Minimally invasive surgery, Prostatic artery embolization, Aquablation, Laser therapies