Reimagining Male Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia Treatment: A New Approach to First-line Interventional Therapy

Benign prostatic hyperplasia is a prevalent condition leading to male lower urinary tract symptoms (mLUTS), particularly in aging populations. Current management strategies-spanning watchful waiting, pharmaceutical therapy, and surgical interventions such as transurethral resection of the prostate-face significant limitations, including side effects, low adherence, and patient hesitancy toward invasive treatments. First-line interventional therapy (FIT) emerges as a novel paradigm bridging the gap between medications and surgery. FIT aims to provide effective, minimally invasive symptom relief with rapid recovery, minimal side effects, and preserved treatment adaptability. Recent advancements in minimally invasive surgical therapies (MISTs) highlight potential; yet existing MIST procedures often fall short of meeting the FIT criteria. An ideal FIT would integrate outpatient feasibility, durability, and patient-centered outcomes, addressing both urologist and patient expectations. By reimagining treatment pathways, FIT has the potential to revolutionize mLUTS management, shifting the standard of care toward early, effective, and patient-friendly interventions, ultimately improving quality of life and long-term bladder health. PATIENT SUMMARY: In this report, we explored new treatment options for men with urinary symptoms caused by an enlarged prostate. We found that many men avoid surgery due to its risks and side effects, while medications often have limited success and unwanted effects. We suggest a new type of treatment, called first-line interventional therapy, which could provide faster symptom relief with fewer risks and quicker recovery, offering a better option for many patients.