Patelli G, Altieri VM, Ierardi AM, Carnevale A, Chizzoli E, Baronchelli F, Trimarchi R, Carrafiello G. Transperineal Laser Ablation of the Prostate for Symptomatic Benign Prostatic Hyperplasia: Long-Term Follow-Up in 40 Patients.
J Vasc Interv Radiol 2024;
35:1187-1193. [PMID:
38705571 DOI:
10.1016/j.jvir.2024.04.023]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 04/09/2024] [Accepted: 04/25/2024] [Indexed: 05/07/2024] Open
Abstract
PURPOSE
To evaluate the durability, effectiveness, and safety of transperineal laser ablation (TPLA) of the prostate.
MATERIALS AND METHODS
Patients with symptomatic benign prostatic hyperplasia (BPH) underwent TPLA with a 1,064-nm continuous-wave diode laser. International Prostate Symptom Score (IPSS), quality of life (QoL), postvoid residual (PVR), and prostate volume were evaluated at baseline and successive timepoints.
RESULTS
Forty prospectively enrolled patients had follow-up of ≥36 months; median duration of follow-up was 57 months (range, 36-76 months). Compared with baseline, the median reduction in IPSS at 12-month follow-up was 74% (interquartile range [IQR], 60%-81%) (P < .001). Median QoL score at 12 months was improved from 5 (IQR, 4-5) at baseline to 1 (IQR, 0-1) (P < .001). Median PVR at 12 months decreased from 108 mL (IQR, 38-178 mL) to 13.5 mL (IQR, 0-40.5 mL) (P < .001), a median reduction of 88% (IQR, 61%-100%). At 12 months, median prostate volume was significantly reduced from 66 mL (IQR, 48.5-86.5 mL) to 46 mL (IQR, 36-65 mL) (P < .001), a median reduction of 32% (IQR, 21%-45%). For all of these parameters, the benefit of TPLA persisted at last follow-up, and all changes were statistically significant compared with baseline. There were no intraprocedural adverse events; periprocedural adverse events consisted of 1 case of prostatitis and 1 case of urinary tract infection (both Society of Interventional Radiology [SIR] Grade I).
CONCLUSIONS
TPLA for symptomatic BPH produced durable benefits across a range of clinical outcomes and was well tolerated in follow-up at median duration of 57 months.
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