The Society of Benign Prostate Disease (SoBPD) held its fourth annual meeting on February 9-10 in Dallas, Texas. As one may expect, the organization has grown tremendously over recent years, paralleling the expanding number of management options for benign prostatic hyperplasia (and the increasing population of patients in need of treatment!). Now at nearly 200 members from 19 countries, the organization grew over 18% from the 2022 to 2023 meetings! The 2024 meeting, cochaired by Kevin T. McVary, MD, and Bradley Gill, MD, MS, spanned basic, translational, and clinical research topics, as well as practical clinical information, tips and tricks, and best practices.

The meeting kicked off with SoBPD President Claus G. Roehrborn, MD, providing an update on the society. Sessions began with basic science and translational research talks from internationally recognized investigators. Douglas W. Strand, PhD, spoke about the cellular basis of benign prostatic hyperplasia (BPH) and how it can facilitate more effective treatments. The role of hypoxia in BPH was discussed William Ricke, PhD, and Brian T. Helfand, MD, PhD, showed how germline genetics can phenotype men with lower urinary tract symptoms (LUTS) to provide more personalized treatments. The session wrapped up with Kevin T. McVary, MD, giving insights into the role metabolic syndrome plays in LUTS/BPH, along with holistic and nonsurgical health interventions that address it.

The morning session continued with a practical session on strategies for optimizing office-based BPH treatment by Kenneth A. Goldberg, MD, and a discussion of the new 2022 changes to coding by Ahmer Farooq, DO. This session wrapped up with insights from Lori B. Lerner, MD, on the role telehealth plays in treating LUTS/BPH. Later in the morning, Adam O. Kadlec, MD, MBA, provided an inspiring talk on his journey and the role of the urologist in developing new treatments and devices.

Controversies and challenges in clinical management were the next focus and began with Gary E. Lemack, MD, providing an in-depth discussion of the complexities stroke and neurogenic factors bring to BPH and retention cases. The management of persistent LUTS after BPH treatment was reviewed by Kenneth A Goldberg, MD, while Bradley Gill, MD, MS, provided excellent insights into the management of concurrent BPH in prostate cancer patients with active surveillance.

The first day was rounded out by a series of engaging (and entertaining!) debates. Moderated by Gary E. Lemack, the “Anti-Cholinergics: Do They Really Cause Dementia?” debate featured Alexis E. Te, MD, arguing for (You’re Crazy If You Think They Don’t) while Roger R. Dmochowski, MD argued against (You’re Crazy If You Think They Do). Next up, R. Charles Welliver, Jr., MD, facilitated a timely point-counterpoint about sequential treatments in BPH management. Arguing for serial minimally invasive interventions (What’s Your Hurry: Chill Out “Dr Health Policy”) was Garrett D. Pohlman, MD, while Wayne Kuang, MD, took on the perspective of a definitive treatment first (Do the Last Operation First Is Good Health Policy). Wrapping up the debates was the “Battle of the Big Prostates” where Alexis E. Te, MD, refereed panelists Alexander P. Glaser, MD (Endoscopic Enucleation), Kevin C. Zorn, MD (Water Jet Ablation), and Bradley Gill, MD, MS (Robotic Simple Prostatectomy) as each insisted their assigned modality was the best for the case!

The final session was an impressive recap of challenging (and frightening) experiences from experts in BPH management. This session, “My Worst BPH Outcomes: Horror Stories from the Other Side,” reviewed complications and their management. Helpful (and humbling) insights and useful strategies for a number of modalities were discussed by Drs McVary, Te, and Roehrborn, and Austen D. Slade, MD. At the conclusion of this session, a wrap-up was provided by Dr Roehrborn before transitioning to the evening reception.

Day 2 started strong with opening remarks from Dr Roehrborn leading into sessions on cutting-edge technologies in BPH. Recent outcomes from paclitaxel-coated prostatic balloon dilation were reviewed by Steven A. Kaplan, MD, and confirmed “Prostatic Balloons: More Than Hot Air” is a true statement. New devices, technologies, and approaches to urodynamic testing were reviewed by Kevin C. Zorn, MD, while Ramy S. Goueli, MD, MHS, covered narcotic-free management pathways for prostatic procedures before delivering an insightful review of the updated AUA BPH clinical guidelines.

The late morning session aroused attendees’ interest in treatments aimed at preserving sexual function. This began with Smita De, MD, PhD, delivering a load of knowledge on what is really known (and what isn’t) about ejaculation in men. The audience was then showered with Tips and Tricks on ejaculation-sparing procedures by Dr Kaplan (prostatic urethral lift), Dr Te (vaporization and resection), Dr Goldberg (water vapor therapy), and Ricardo R Gonzalez, MD (water jet ablation). Coming out of this stimulating session, it was abundantly clear BPH treatment has become much more patient-centric than years past with the array of management options urologists now have on hand.

Continuing along the vein of technology and innovation, a fascinating talk by Dr Roehrborn showed BPH treatment outcome predictions using a simulation model. This was complemented by a thought-provoking overview of artificial intelligence in the diagnosis and management of BPH. As technology progresses and the world becomes increasingly digitized, it is likely at-home diagnostic testing and data collection will replace (or least augment) that obtained in the clinic, and we may be able to use data to help patients decide upon optimal treatments for their specific situations.

The afternoon provided contemporary updates on several topics. An update on prostatic artery embolization was given by Ankit Mehta, MD, while Scott Bauer, MD, ScM, provided a review of the potential harms of BPH medications. An excellent dissection of nocturia and its treatment was provided by Dr Lerner. Finally, surveys of the literature were provided by Dr Welliver (most important medically focused BPH/LUTS papers of the past 2 years) and Dr Zorn (most important surgically focused).

The meeting then concluded with a message and motivating sendoff from Dr Roehrborn, which included previews of the exciting AUA 2024 program (May 6, 2024) as well as a call to action and overview on plans for growth and expansion of the organization. Avenues for involvement in SoBPD were outlined, including several positions on newly formed committees aimed at education, digital communications, and society membership/planning. One highlight of his message was the many opportunities the SoBPD affords its members (especially younger/early career) for career development, peer engagement, and helping shape the future of the treatment of prostatic disease.