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Transperineal Laser Ablation for Percutaneous Treatment of Benign Prostatic Hyperplasia: A Feasibility Study

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Abstract

Purpose

To assess the feasibility and safety of transperineal laser ablation (TPLA) for treating benign prostatic hyperplasia (BPH).

Materials and Methods

Institutional review board approval was obtained for this prospective non-randomized trial. Eightteen patients (age 71.7 ± 9.4 years) with urinary symptoms secondary to BPH underwent TPLA under local anesthesia. Under US guidance, up to four 21G applicators were inserted in the prostatic tissue. Each treatment was performed with diode laser operating at 1064 nm changing the illumination time according to prostate size. Primary endpoints were technical success and safety of TPLA. Secondary endpoints included operation time, ablation time, energy deployed, hospitalization time, catheterization time, and change in International Prostate Symptom Score (IPSS), Quality of Life (QoL), peak urinary flow rate (Q max), post-void residual (PVR), and prostatic volume at 3 months. χ 2 and Fisher exact tests were used.

Results

All procedures were technically successful. No complications occurred. Mean operation time was 43.3 ± 8.7 min, mean ablation time 15.9 ± 3.9 min, mean energy deployed 10,522 ± 3290.5 J, mean hospital stay 1.5 ± 0.4 days, and mean catheterization time 17.3 ± 10.0 days. At 3 months, IPSS improved from 21.9 to 10.7 (P < 0.001), QoL from 4.7 ± 0.6 to 2.1 ± 1.2 (P < 0.001), Q max from 7.6 to 13.3 mL/s (P = 0.001), PVR from 199.9 ± 147.3 to 81.5 ± 97.8 (P < 0.001), and mean prostate volume from 69.8 to 54.8 mL (P < 0.001).

Conclusions

TPLA is feasible and safe in the treatment of BPH, providing significant clinical results at 3 months.

Level of Evidence

Case series, Level IV.

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Authors and Affiliations

  1. Department of Interventional Radiology, Pesenti-Fenaroli Hospital-ASST Bergamo Est, 24022, Alzano Lombardo, Italy

    Gianluigi Patelli

  2. Department of Urology, Pesenti-Fenaroli Hospital-ASST Bergamo Est, 24022, Alzano Lombardo, Italy

    Antonio Ranieri & Aurelio Paganelli

  3. Department of Interventional Radiology, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy

    Giovanni Mauri

  4. Department of Diagnostic Imaging and Interventional Radiology, “Regina Apostolorum” Hospital, 00041, Alzano Lombardo, Italy

    Claudio Maurizio Pacella

Authors
  1. Gianluigi Patelli
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  2. Antonio Ranieri
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  3. Aurelio Paganelli
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  4. Giovanni Mauri
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  5. Claudio Maurizio Pacella
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Corresponding author

Correspondence to Giovanni Mauri.

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Conflict of interest

Claudio Maurizio Pacella is consultant for Elesta s.r.l. All other authors have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Patelli, G., Ranieri, A., Paganelli, A. et al. Transperineal Laser Ablation for Percutaneous Treatment of Benign Prostatic Hyperplasia: A Feasibility Study. Cardiovasc Intervent Radiol 40, 1440–1446 (2017). https://doi.org/10.1007/s00270-017-1662-9

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  • DOI: https://doi.org/10.1007/s00270-017-1662-9

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