DESCRIPTION
Balloon dilatation of the prostatic urethra, or balloon urethroplasty, is a therapeutic procedure intended to manage symptoms associated with benign prostatic hypertrophy (BPH). Under fluoroscopic guidance, a flexible catheter with a balloon attachment is placed in the urethra at the level of the prostate above the external sphincter. The balloon is then inflated for a short period of time to distend the prostatic urethra. This widening process is intended to relieve obstruction of the urethra caused by the enlarged prostate and to alleviate the symptoms of benign prostatic hypertrophy (e.g., urinary retention, urgency, hesitancy, nocturia, and dysuria). No surgical specimen is collected. This procedure can be done in an outpatient facility.
POLICY
Balloon dilatation of the prostatic urethra for the treatment of benign prostatic hypertrophy (BPH) is considered investigational.
See also:
Transurethral Radiofrequency Needle Ablation of the Prostate (TUNA)
Water-Induced Thermotherapy (WIT) for the Treatment Benign Prostatic Hypertrophy
ADDITIONAL INFORMATION
No evidence was found in the available literature to validate the safety and efficacy of balloon dilatation of the prostatic urethra for the treatment of benign prostatic hypertrophy.
SOURCES
American Urological Association. (2003). Guideline on the management of benign prostatic hypertrophy. Retrieved March 20, 2009 from. http://www.auanet.org/content/homepage/homepage.cfm.
BlueCross BlueShield Association. Medical Policy Reference Manual. (3:2003). Balloon Dilatation of Prostate (7.01.04). Retrieved March 20, 2009 from BlueWeb.
Chiou, R. K., Binard, J. E., Ebersole, M. E., Horan, J. J., Chiou, Y. K., & Lynch, B. (1994). Randomized comparison of balloon dilation and transurethral incision for treatment of symptomatic benign prostatic hyperplasia. Journal of Endourology / Endourological Society, 8 (3), 221-224. (Level 4 Evidence)
Renfer, L., Thompson, I. M., Desmond, P. M., Zeidman, E. J., & Mueller, E. J. (1995). Balloon dilation of the prostate: correlation with magnetic resonance imaging and transrectal Ultrasound findings. Journal of Endourology / Endourological Society, 9 (3), 283-286. (Level 4 Evidence)
Santucci, R. A., & McAninch, J. W. (2002). Urethral reconstruction of strictures resulting from treatment of benign prostatic hypertrophy and prostate cancer. Urologic Clinics of North America, 29 (2), 417-427. (Level 5 Evidence)
Saporta, L., Aridogan, I. A., Erlich, N., & Yachia, D. (1996). Objective and subjective comparison of transurethral resection, transurethral incision and balloon dilatation of the prostate. European Urology, 29 (4), 439-445. (Level 4 Evidence)
Urological Associates: Published Papers. (n. d.).Transurethral balloon divulsion of prostate. Retrieved March 20, 2009 from http://www.urological.com/papers/prostate.html.
ORIGINAL EFFECTIVE DATE: 3/1990
MOST RECENT REVIEW DATE: 5/14/2009
ID_BA
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