PubMed Central, : RMMJ Rambam Maimonides Medical Journal Rambam Health Care Campus 2026; 17(1): e0003. ISSN: 2076-9172Published online 2026 January 28. doi: 10.5041/RMMJ.10564

Table 1.

Summary of Surgical Options for Management of Bladder Outlet Obstruction in Metastatic Prostate Cancer.

Procedure	Indications	Advantages	Limitations/Considerations
TURP	Used for urinary retention relief or obstructive symptoms in locally advanced or metastatic disease	Well-established, widely available, and provides rapid symptom relief	May require re-intervention; limited evidence on oncologic impact in the metastatic setting
HoLEP	Applied for BOO or urinary retention, particularly in larger glands or in patients under systemic therapy	Associated with reduced bleeding risk and durable symptom control	Requires specific expertise; limited prospective data in metastatic prostate cancer
GreenLight PVP	Considered a minimally invasive option for patients unfit for TURP or HoLEP	Provides functional improvement with a favorable safety profile	Evidence remains limited; oncologic benefit not yet established

BOO, bladder outlet obstruction; HoLEP, holmium laser enucleation of the prostate; PVP, photoselective vaporization of the prostate; TURP, transurethral resection of the prostate.

RMMJ Rambam Maimonides Medical Journal Rambam Health Care Campus 2026; 17(1): e0003. ISSN: 2076-9172

Published online 2026 January 28. doi: 10.5041/RMMJ.10564