OP68 Treatment Of Benign Prostatic Hyperplasia Among Remote Indigenous Populations - Experience With A Minimally Invasive Therapy In The Brazilian Amazon Rainforest

Sep 29, 2026

Benign prostatic hyperplasia causes progressive lower urinary tract symptoms, which can culminate in acute urinary retention and renal failure, leaving indigenous and remote communities disproportionately affected despite effective treatment in urban centers. In October 2024, a six-person team conducted community screening and delivered minimally invasive care using a mobile surgical center with controlled sterile conditions. Fourteen procedures were performed with the Rezūm water vapor therapy, with rapid resolution of expedition challenges. Findings support feasibility, adaptability, and potential transformative impact of innovative technologies for remote access.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Introduction

Methods

Results

Conclusions

OP67 Advancing Toward Environmental Impact Assessment In Health Technology Assessment Mireille M. Goetghebeur, Rossella Di Bidino, Juliana Yi, Matthias Perleth, Rebecca Boyce, Li-Ying Huang, Fiona Campbell, Hans C. Ossebaard and Tara Schuller ([inahta@ihe.ca](inahta@ihe.ca)) Introduction: The world is facing an urgent environmental emergency that calls for ambitious, coordinated action by governments to improve humankind’s relationship with nature. Mitigation (reducing pollution) and adaptation (adjusting to pollution) are both necessary, and “NextGen” health technology assessment can play a key role in helping to guide health system decision-makers to achieve environmental sustainability. Methods: In 2022, the International Network of Agencies for Health Technology Assessment(INAHTA)identified environmental impact assessment (EIA) as an important and urgent topic for a white paper. An international author group(n=10), formed ofstafffrom INAHTA member agencies, wrote the paper. The author group met seven times over 2022 to 2024 to develop the paper, which is based on a literature review and expert opinion ofINAHTA members. A second group of members formed an international advisory group (n=11), which reviewed the draft twice. The paper was approved by the INAHTABoard before release on the INAHTA website. Results: EIA can be useful to help achieve the “green” policy goals of health systems by identifying technologies that are comparatively harmful to the environment. However, health technology assessment (HTA) agencies are subject to the institutional structures and regulations of their local health system that can constrain their ability to independently adapt to incorporate EIA. Nevertheless, HTA agencies are starting to do this with some success, but difficult challenges remain, particularly around lack of data and methods. Looking ahead, raising awareness and working together across the HTA ecosystem will be key to achieving the shared goal of environmental sustainability. Conclusions: The successful inclusion of EIA in priority setting, assessment, and appraisal, as well as knowledge sharing and dissemination activities ofHTA, is a challenge since the operating principles, methods, and data in this area are not yet mature. The successful inclusion of environmental impacts in HTA will require some reconsideration of existing value frameworks and methods. OP68 Treatment Of Benign Prostatic Hyperplasia Among Remote Indigenous Populations: Experience With A Minimally Invasive Therapy In The Brazilian Amazon Rainforest Maiara Antonio ([maiara.antonio@bsci.com](maiara.antonio@bsci.com)), Isabela Horti, Henrique Tortele, Anna Pereira and Murilo Contó Introduction: Initial symptoms of benign prostatic hyperplasia (BPH) include difficulty urinating and low urinary flow. Worsening ofBPH can lead to acute urinary retention and renal failure. Although it is fully treatable in urban centers, indigenous and remote area people are severely impacted. The experience presented herein showshow minimally invasive treatments can promote access to health care even in remote areas. Methods: In October 2024, after 48 hours of travel—two flights and more than six hours by boat—a team of six people in association with a specialized non-governmental organization arrived at the community of Assunção do Içana, in the middle of the Brazilian Amazon rainforest. Screening of the community population with BPH was initiated a year earlier and eligibility was double-checked with the lower urinary tract symptoms visual score and ultrasound. Patient interest in undergoing the procedure was a criterion. A mobile surgical center was set up in the community. Waterproof and thermally insulating materials were used to create a controlled environment, with adequate temperature and sterile conditions. Results: A general practitioner specialized in indigenous health initially screened 180 patients, and 14 procedures were performed by a urologi

FAQs

What medical problems does benign prostatic hyperplasia cause in the introduction?

Initial symptoms include difficulty urinating and low urinary flow. Worsening can lead to acute urinary retention and renal failure.

How was the procedure team and screening organized in the methods?

In October 2024, the team traveled to Assunção do Içana, screened the community population, and confirmed eligibility using lower urinary tract symptom visual scores and ultrasound. Patient interest was also a criterion.

What therapy was used and what were key time metrics in the results?

A urologist performed 14 procedures, including Rezūm water vapor therapy. Mean room time was 55 minutes and anesthesia-to-catheter placement time was 29 minutes, with field time and device use taking about 20 minutes and four minutes respectively.

Sep 29, 2026

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