Ep. 215 HoLEP vs MIST: Patient Selection and Outcomes with Dr. Marawan El Tayeb

With the abundance of interventional options for benign prostate hyperplasia (BPH), how do you decide on the best treatment for each individual patient? In this episode of BackTable Urology, Dr. Marawan El Tayeb, chief of urology at Baylor Scott and White-Temple, joins host Dr. Jose Silva to discuss the intricacies of decision-making in BPH treatment. --- SYNPOSIS The urologists discuss advantages and disadvantages of various BPH interventions, providing insight on when to use what. The conversation then goes deeper on holmium laser enucleation of the prostate (HoLEP), emphasizing the importance of appropriate patient counseling about retrograde ejaculation and transient urinary incontinence. Dr. El Tayeb shares his experiences in managing BPH both medically and surgically. He details his procedural approach, patient selection criteria, and postoperative care, along with special considerations for patients with prostate cancer on active surveillance. The episode concludes with a detailed look at alternative prostate treatments and insights into upcoming technological advancements in prostate care. --- TIMESTAMPS 00:00 - Introduction 02:44 - Evolution of BPH Treatments 09:40 - Weighing BPH Procedures 14:33 - HoLEP Insights 20:59 - Understanding HoLEP Equipment 21:06 - Techniques for Intravesical Lobes 24:10 - Post-Procedure Decisions 30:33 - Special Considerations for Cancer Patients 40:24 - Alternative Treatments and Final Thoughts