From the Guidelines
The Optilume procedure is a suitable treatment option for men with moderate benign prostatic hyperplasia (BPH) symptoms who have not responded to oral medications and wish to avoid more invasive surgical options. The procedure involves inserting a catheter with a balloon coated with paclitaxel into the urethra, then inflating it to stretch the prostatic tissue while delivering the medication to prevent tissue regrowth. Suitable candidates for Optilume are typically men with moderate BPH symptoms, prostates smaller than 80 grams, no median lobe enlargement, and no history of prior prostate surgery 1. The procedure is performed on an outpatient basis under local anesthesia with sedation, takes approximately 15-30 minutes, and patients can usually return home the same day. Recovery is relatively quick, with most men experiencing symptom improvement within days to weeks. The mechanism works by both mechanically opening the prostatic urethra through dilation and chemically preventing tissue regrowth through the paclitaxel coating, which inhibits cell division in the treated area. Some key points to consider when evaluating a patient for the Optilume procedure include:
- The patient's symptom severity and impact on quality of life
- The size and shape of the prostate, as well as the presence of any median lobe enlargement
- The patient's medical history, including any prior prostate surgery or treatments
- The patient's preferences and goals for treatment, including their willingness to undergo a minimally invasive procedure versus a more invasive surgical option. According to the AUA guideline on management of BPH, patients with moderate to severe symptoms who are bothered by their symptoms should be considered for treatment, and the Optilume procedure is a viable option for these patients 1. It is essential to discuss the benefits and risks of the Optilume procedure with the patient, as well as the potential outcomes and alternatives, to ensure that the patient makes an informed decision about their treatment. In terms of specific patient selection criteria, the AUA guideline recommends that patients with prostates smaller than 80 grams and no median lobe enlargement are ideal candidates for minimally invasive therapies like Optilume 1. Additionally, patients with a history of prior prostate surgery or other underlying medical conditions may not be suitable candidates for the Optilume procedure, and alternative treatment options should be considered. Overall, the Optilume procedure is a safe and effective treatment option for men with moderate BPH symptoms who meet the selection criteria and are looking for a minimally invasive alternative to more invasive surgical options.
From the Research
Optilume Procedure for Benign Prostatic Hyperplasia (BPH)
The Optilume procedure is a minimally invasive surgical therapy for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) 2, 3, 4, 5. It involves the use of a drug-coated balloon catheter system, which is inserted into the prostatic urethra to treat LUTS.
Suitable Candidates for the Optilume Procedure
Suitable candidates for the Optilume procedure are men over 50 years old with moderate-to-severe LUTS secondary to BPH, a peak urinary flow rate of 5-15 ml/s, prostatic urethra length of 30-55 mm, and prostate volume of 20-80 g 2. Additionally, men with symptomatic BPH and a prostate size between 20 and 80 g may also be eligible for the procedure 4.
Key Benefits of the Optilume Procedure
The Optilume procedure has been shown to provide several benefits, including:
- Improvement in LUTS, with a significant reduction in International Prostate Symptom Score (IPSS) and IPSS quality of life 2, 3, 4, 5
- Improvement in urinary flow, with an increase in peak urinary flow rate (Qmax) 2, 3, 4, 5
- Relief of obstruction, with a reduction in postvoid residual urine volume (PVR) 3, 5
- Minimally invasive, with a low risk of complications and no impact on sexual function 3, 4, 5
Long-term Outcomes
Long-term follow-up studies have shown that the benefits of the Optilume procedure are durable, with significant improvements in LUTS and urinary flow maintained through 1-4 years after treatment 2, 3, 5. The procedure has been shown to be safe and well-tolerated, with no treatment-related adverse events reported in the long-term follow-up period 5.