Catheter-dependent urinary retention is a severe manifestation of benign prostatic obstruction, frequently affecting older and comorbid patients not eligible for standard surgery. Minimally invasive surgical therapies (MISTs) may be alternative options, although catheter-dependent men are often excluded from pivotal trials.
A structured review of studies reporting outcomes of MISTs in this population was performed.
Twenty-four studies including 1137 patients were identified, mostly retrospective, single-arm, and monocentric.
Duration of preoperative catheter dependence varied widely (2-47 wks). Across MIST modalities, catheter-free rates (CFR) ranged from 66% to 100%.
Prostatic artery embolization and water vapor thermal therapy (Rezūm) were the most frequently evaluated treatments, with CFR of 66-95.2% and 68-100%, respectively, and reintervention rates generally below 15%.
Major complications were uncommon. Overall, MISTs can achieve high CFR with low major morbidity in selected patients, but evidence remains heterogeneous, highlighting the need for standardized outcomes and comparative studies.
European urology focus. 2026 Mar 25 [Epub ahead of print]
Pietro Scilipoti, Marie Chicaud, Mikael Abi Abdallah, Nathan Wirtzfeld, Stefano Moretto, Stessy Kutchukian, Steeve Doizi
Sorbonne Université, GRC n°39, Santé de l'homme, Hôpital Tenon, Paris, France., Endolase Lab, GRC 20-Sorbonne Université and PIMM-Arts et Métiers ParisTech, Paris, France; Department of Urology, Limoges University Hospital, 2 Av. Martin Luther King, Limoges, France; Progress and Collaboration in Endourology Group (PACE), Paris, France; Sorbonne Université, Service d'Urologie, AP-HP, Hôpital Tenon, Paris, France., Department of Urology, Poitiers University Hospital, 2 Rue de la Milétrie, Poitiers, France., Sorbonne Université, GRC n°39, Santé de l'homme, Hôpital Tenon, Paris, France; Endolase Lab, GRC 20-Sorbonne Université and PIMM-Arts et Métiers ParisTech, Paris, France; Progress and Collaboration in Endourology Group (PACE), Paris, France., Sorbonne Université, GRC n°39, Santé de l'homme, Hôpital Tenon, Paris, France; Endolase Lab, GRC 20-Sorbonne Université and PIMM-Arts et Métiers ParisTech, Paris, France; Progress and Collaboration in Endourology Group (PACE), Paris, France; Department of Urology, Poitiers University Hospital, 2 Rue de la Milétrie, Poitiers, France., Sorbonne Université, GRC n°39, Santé de l'homme, Hôpital Tenon, Paris, France; Endolase Lab, GRC 20-Sorbonne Université and PIMM-Arts et Métiers ParisTech, Paris, France; Sorbonne Université, Service d'Urologie, AP-HP, Hôpital Tenon, Paris, France; Endourology Technology Section of European Association of Urology (EAU), Arnhem, The Netherlands. Electronic address: .