{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:33:16Z","timestamp":1787772796162,"version":"build-2784847793"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Minimally invasive surgical treatments (MISTs) are many promising approaches for the management of benign prostate hyperplasia (BPH) that might be performed under local anesthesia (LA) and have same-day discharge. To address the feasibility and efficacy of LA for BPH-MIST, a specific trifecta was conceptualized and tested: (1) no intraoperative complications, (2) reduced intraoperative pain, and (3) same-day discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>We prospectively collected data from patients who underwent Rezum, Urolift, and iTIND treatments from January 01, 2023, to February 28, 2024, on an international database. All the patients received a local administration of two anesthetic gels in the urethra before the procedure; selected patients, in addition, received a transperineal anesthetic injection in the periprostatic space or transurethrally with a Schelin Catheter (SC) injection directly in the prostatic lobes. Reduced intraoperative pain was defined as &lt;5 on the visual analogue scale (VAS range: 0\u201310).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Overall, 156 patients were included in the study. Median age was 63.5 (interquartile range [IQR]: 56\u201370) years. Eleven patients (7.0%) had diabetes, and 29 (18.6%) received anticoagulant medication. Ten patients (6.4%) had indwelling catheters. The median prostate size was 45 ml (IQR: 34\u201360). Forty-eight patients underwent Urolift (30.8%), 70 (44.8%) Rezum, and 38 (24.4%) iTIND. The transperineal block and the SC were used in 21 patients (13.5%) and 32 (20.5%) patients, respectively, with 103 (66%) patients receiving only the anesthetic gels in the urethra. Performing MIST in pure LA achieved the trifecta outcome in 122 patients (78.2%). Six patients (3.8%) had intraoperative complications. One hundred and thirty patients (83.3%) experienced reduced intraoperative pain (&lt;5 on VAS). One hundred and 47 (94.2%) patients were discharged on the same day of the procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>LA for MIST in BPH is feasible, with excellent success rates and reduced pain, as trifecta outcomes were achieved.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ua.ua_41_25","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T11:02:04Z","timestamp":1760698924000},"page":"233-238","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Trifecta outcomes to assess the feasibility of local anesthesia for benign prostate hyperplasia minimally invasive surgical treatments"],"prefix":"10.4103","volume":"17","author":[{"given":"Alberto","family":"Olivero","sequence":"first","affiliation":[{"name":"Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy"},{"name":"European Association of Urology-Young Academic Urologists Urolithiasis and Endourology Working Group, Arnhem, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinan","family":"Khadhouri","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, University of St. Andrews, St Andrews, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Palagonia","sequence":"additional","affiliation":[{"name":"Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Dell\u2019Oglio","sequence":"additional","affiliation":[{"name":"Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy"},{"name":"Department of Urology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Amsterdam, Netherlands"},{"name":"Department of Radiology, Interventional Molecular Imaging Laboratory, Leiden University Medical Center, Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Tappero","sequence":"additional","affiliation":[{"name":"Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barend","family":"Dreyer","sequence":"additional","affiliation":[{"name":"Department of Urology, NHS Fife, Victoria Hospital, Kirkcaldy, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldo Massimo","family":"Bocciardi","sequence":"additional","affiliation":[{"name":"Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Caviglia","sequence":"additional","affiliation":[{"name":"Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Galfano","sequence":"additional","affiliation":[{"name":"Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feras","family":"Al Jaafari","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, University of St. Andrews, St Andrews, UK"},{"name":"Department of Urology, NHS Fife, Victoria Hospital, Kirkcaldy, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhaskar K.","family":"Somani","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia","family":"Pietropaolo","sequence":"additional","affiliation":[{"name":"European Association of Urology-Young Academic Urologists Urolithiasis and Endourology Working Group, Arnhem, Netherlands"},{"name":"Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Secco","sequence":"additional","affiliation":[{"name":"Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"key":"R1-20251017","doi-asserted-by":"crossref","first-page":"389","DOI":"10.23736\/S2724-6051.21.04530-4","article-title":"Emerging minimally invasive transurethral treatments for benign prostatic hyperplasia: A systematic review with meta-analysis of functional outcomes and description of complications","volume":"74","author":"Manfredi","year":"2022","journal-title":"Minerva Urol 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Let\u2019s be fair: iTIND, Urolift and Rez\u016bm","volume":"39","author":"Suarez-Ibarrola","year":"2021","journal-title":"World J Urol"},{"key":"R13-20251017","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.urology.2019.11.078","article-title":"Transperineal free-hand mpMRI fusion-targeted biopsies under local anesthesia: Technique and feasibility from a single-center prospective study","volume":"140","author":"Marra","year":"2020","journal-title":"Urology"},{"key":"R14-20251017","article-title":"Use of a Schelin catheter for transurethral intraprostatic anesthesia (TUIA) prior to iTIND procedure","author":"Secco","year":"2024","journal-title":"Prostate Cancer Prostatic Dis"},{"key":"R15-20251017","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1046\/j.1464-410X.1996.24117.x","article-title":"Patient acceptability of transurethral incision of the prostate under local anaesthesia","volume":"78","author":"Irani","year":"1996","journal-title":"Br J 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History"}},{"value":"2025-06-23","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}