Commentary on “Changes in Prevalence and Treatment Pattern of Benign Prostatic Hyperplasia in Korea”

Article information

Int Neurourol J. 2021;25(4):364-364
Publication date (electronic) : 2021 December 31
doi :
1Department of Urology, Jeonbuk National University Medical School, and Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
2Department of Urology, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea
3Department of Urology, Gyeongsang National University College of Medicine, and lnstitute of Health Sciences of Gyeongsang National University Jinju, Gyeongsang National University Changwon Hospital, Changwon, Korea
Corresponding author: Sung Chul Department of Urology, Gyeongsang National University Changwon, Hospital, 11 Samjeongja-ro, Seongsan-gu, Changwon 51472, Korea Email:
Received 2021 February 7; Accepted 2021 February 22.

To the editor,

We have carefully read the article published in International Neurourology Journal by Jo et al., and their findings are indeed interesting [1]. This article is one of the few reports that has addressed the issue of treatment patterns of benign prostatic hyperplasia (BPH) in South Korea. The authors evaluated the treatment pattern of BPH, including the types of surgery performed [1]. In their study, between 2012 and 2016, transurethral resection of the prostate (TURP) was the most commonly used surgical treatment for BPH (53.6%), but it showed a decreasing pattern over time, whereas holmium laser enucleation of the prostate (HoLEP) showed an increase from 19.4% to 39.7% [1]. Indeed, HoLEP is a minimally invasive procedure for lower urinary tract symptoms suggestive of BPH, unlike TURP [2]. However, HoLEP does also carry a risk of postoperative complications, including urethral stricture, incontinence, retrograde ejaculation, and bladder neck contraction [3]. Over recent years, novel minimally invasive surgical treatments (MISTs) such as the prostatic urethral lift (Urolift system), convective water vapor energy (REZUM system), and Aquablation (Aquabeam system) have entered into the field of BPH treatment. MISTs aim to be effective, ideally to be performed in an outpatient setting under only local anesthesia, and to offer more favorable safety results than existing techniques. Considering those potential benefits from MISTs, we believe that the adoption of these procedures for BPH is reasonable because one of the key topics of future medical practice is patient-centered quality of medical care, encompassing safe and MISTs. We hope that the authors will conduct a future study on changing treatment patterns for BPH after 2016, and we await the results that the proportion of MISTs is increasing in BPH surgery.


Conflict of Interest

No potential conflict of interest relevant to this article was reported.


1. Jo JK, Shinn SH, Kim KS, Moon HS. Changes in prevalence and treatment pattern of benign prostatic hyperplasia in Korea. Int Neurourol J 2021;25:347–54.
2. Park JK, Kim JY, You JH, Choi BR, Kam SC, Kim MK, et al. Effect of preoperative urethral dilatation on preventing urethral stricture after holmium laser enucleation of the prostate: a randomized controlled study. Can Urol Assoc J 2019;13:E357–60.
3. Kim M, Shin YS, ; KSSMA RASP group. It’s time to take advantage of robotic assisted simple prostatectomy in large benign prostatic hyperplasia. World J Mens Health 2019;37:374–5.

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