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Current Urology Reports
Published in: Current Urology Reports 8/2021

01-08-2021 | Overactive Bladder | Benign Prostatic Hyperplasia (J Silberstein and C Benson, Section Editors)

How I Handle Retreatment of LUTS Following a Failed MIST

Authors: Alexis E. Te, Ahra Cho, Bilal I. Chughtai

Published in: Current Urology Reports | Issue 8/2021

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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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Metadata
Title
How I Handle Retreatment of LUTS Following a Failed MIST
Authors
Alexis E. Te
Ahra Cho
Bilal I. Chughtai
Publication date
01-08-2021
Publisher
Springer US
Published in
Current Urology Reports / Issue 8/2021
Print ISSN: 1527-2737
Electronic ISSN: 1534-6285
DOI
https://doi.org/10.1007/s11934-021-01054-w