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How I Handle Retreatment of LUTS Following a Failed MIST

  • Benign Prostatic Hyperplasia (J Silberstein and C Benson, Section Editors)
  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The goal of this paper is to review retreatment management after failed minimally invasive treatment (MIST) of various technologies.

Recent Findings

A failed MIST can be defined by the return, persistence, or worsening of LUTS, as documented by symptom scores. Persistence, development, or recurrence of comorbidities such as recurrent urinary tract infection (UTI), retention, stones, hematuria, and incontinence can also signal a failed MIST.

Summary

The common etiology for MIST failure is the preoperative consequence of long-term bladder outlet obstruction (BOO) on the bladder function. Close monitoring of therapies with antimuscarinics or beta-agonists can be empirically utilized if post-void bladder residual (PVR) is low. If there is a high PVR, urodynamic studies and cystoscopy can be used to determine overactive bladder (OAB), BOO, or necrosis. Depending on the timing of the observed BOO/OAB, subsequent retreatments involving transurethral debridement, medical and behavioral therapies, or repeat surgical debulking can be employed.

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Authors and Affiliations

  1. Department of Urology, Weill Cornell Medical College of Cornell University, 425 East 61st street, 12th floor, New York, NY, 10065, USA

    Alexis E. Te, Ahra Cho & Bilal I. Chughtai

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  1. Alexis E. Te
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  2. Ahra Cho
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Correspondence to Alexis E. Te.

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Conflict of Interest

Dr. Alexis Te and Ahra Cho do not have financial conflicts to disclose. Dr. Bilal Chughtai is a consultant to Boston Scientific, Olympus, Medi-Tate, Medeon Bio, Urovant, and Ferring.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Te, A.E., Cho, A. & Chughtai, B.I. How I Handle Retreatment of LUTS Following a Failed MIST. Curr Urol Rep 22, 40 (2021). https://doi.org/10.1007/s11934-021-01054-w

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