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The following is a summary of “Surgical treatment of lower urinary tract symptoms secondary to benign prostatic obstruction: an analysis and meta-synthesis of available guidelines,” published in the April 2025 issue of BMC Urology by Matter et al. 

The rise of minimally invasive treatments (MITs) for lower urinary tract symptoms secondary to benign prostatic obstruction (LUTS/BPO) has expanded surgical options. However, these options often outpace the available solid evidence. 

Researchers conducted a retrospective study on the diverse treatments for LUTS/BPO, which confuse physicians as clinical guidelines vary in evidence interpretation. 

They analyzed available guidelines on the surgical treatment of LUTS/BPO updated within the last 3 years, focusing on those offering specific procedural recommendations. They compared recommendations, analyzed discrepancies, and developed a consensus algorithm incorporating all pertinent advice. 

The results showed that out of 14 guidelines, 4 met the inclusion criteria. Major challenges included inconsistent nomenclature and unclear recommendations, particularly for newer procedures like iTIND ^TM, prostate artery embolization (PAE), robotic assisted simple prostatectomy (RASP), and Rezūm^TM. Despite these issues, a consensus algorithm was synthesized. 

Investigators emphasized the evolving complexity in LUTS/BPO management and highlighted the need for standardized evidence criteria in guideline recommendations. The consensus algorithm aimed to aid urologists in decision-making and patient counseling. 

Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-025-01788-6