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Transurethral ethanol ablation of the prostate (TEAP): an effective minimally invasive treatment alternative to traditional surgery for symptomatic benign prostatic hyperplasia (BPH) in high-risk comorbidity patients

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Abstract

Objective

To evaluate the efficacy and safety of transurethral ethanol ablation of the prostate (TEAP) for patients with symptomatic benign prostatic hyperplasia (BPH) and high-risk comorbidities.

Materials and methods

Thirty-six patients (mean age 77.3 years) with symptomatic BPH or persistent urinary retention were assessed at baseline and at 3, 6, and 12 months after treatment. All patients were affected by comorbidities (cardiovascular, respiratory, hematologic, neoplastic, dysmetabolic diseases, or coagulation disorders). Baseline evaluation was achieved by the International Prostate Symptom Score (IPSS) and quality of life (QoL) score, prostate-specific antigen (PSA), prostate transrectal ultrasound (TRUS), and the maximum peak flow rate with evaluation of post-voiding residual urine volume (PVR). Treatment was performed by injecting dehydrated ethanol at a rate correlated to prostate volume into the prostate. The primary end-point for response was ≥80% improvement of the maximum peak flow rate and significant reduction of the PVR; secondary end-points included symptom improvement (≥40% reduction in IPSS and QoL scores). Statistical analysis was carried out with Pearson’s Chi-square test and the non-parametric Wilcoxon test with an assigned statistical significance at P < 0.05.

Results

During the active follow-up period, we observed a statistically significant decrease of the baseline at the end of the study in the total IPSS score and in the QoL score. The mean peak flow rate improved from 6.0 ± 2.40 ml/min to 15.2 ± 0.14 ml/min (P < 0.001), while the PVR decreased from a baseline value of 290.6 ± 14.14 ml to 4.2 ± 14.10 ml (P < 0.001).

Conclusion

We found that TEAP is a safe minimally invasive treatment, which significantly improves voiding dysfunctions in patients with symptomatic BPH.

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References

  1. Cabelin MA, Te AE, Kaplan SA (2000) Benign prostatic hyperplasia: challenges for the new millennium. Curr Opin Urol 10:301–306

    Article  PubMed  CAS  Google Scholar 

  2. Schumm-Draeger PM (1998) Ultrasound-guided percutaneous ethanol injection in the treatment of autonomous thyroid nodules—a review. Exp Clin Endocrinol Diabetes 106(4):S59–S62

    Article  PubMed  CAS  Google Scholar 

  3. Livraghi T, Festi D, Monti F et al (1986) US-guided percutaneous alcohol injection of small hepatic and abdominal tumors. Radiology 161:309–312

    PubMed  CAS  Google Scholar 

  4. Banner M (1998) Percutaneous renal cyst ablation. In: Banner M (ed) Radiologic interventions uroradiology. Williams & Wilkins, Baltimore, pp 73–77

    Google Scholar 

  5. Gelezer RK, Charbonneau JW, Hussain S et al (1999) Ethanol injection therapy of the prostate for benign prostatic hyperplasia: preliminary report on application of a new technique. J Urol 162:383–386

    Article  Google Scholar 

  6. Harkaway RC, Issa MM (2006) Medical and minimally invasive therapies for the treatment of benign prostatic hyperplasia. Prostate Cancer Prostatic Dis 9(3):204–214

    Article  PubMed  CAS  Google Scholar 

  7. Stovsky MD, Griffiths RI, Duff SB (2006) A clinical outcomes and cost analysis comparing photoselective vaporization of the prostate to alternative minimally invasive therapies and transurethral prostate resection for the treatment of benign prostatic hyperplasia. J Urol 176:1500–1506

    Article  PubMed  Google Scholar 

  8. Mebust WK, Holtgrewe HL, Cockett AT et al (2002) Transurethral prostatectomy: immediate and postoperative complications. A cooperative study of 13 participating institutions evaluating 3,885 patients. 1989. J Urol 167(2 Pt 2):999–1003

    Article  PubMed  CAS  Google Scholar 

  9. Larson TR (2002) Rationale and assessment of minimally invasive approaches to benign prostatic hyperplasia therapy. Urology 59(2 Suppl 1):12–16

    Article  PubMed  Google Scholar 

  10. AUA Practice Guidelines Committee (2003) AUA guideline on management of benign prostatic hyperplasia (2003). Chapter 1: diagnosis and treatment recommendations. J Urol 170:530–547

    Article  Google Scholar 

  11. de la Rosette J, Alivizatos G, Madersbacher S et al, European Association of Urology (2001) EAU guidelines on benign prostatic hyperplasia (BPH). Eur Urol 40:256–264

    Article  PubMed  Google Scholar 

  12. Zvara P, Karpaman E, Stoppacher R et al (1999) Ablation of canine prostate using transurethral intraprostatic absolute ethanol injection. Urology 54:411–415

    Article  PubMed  CAS  Google Scholar 

  13. Plante MK, Bunnell ML, Trotter SJ et al (2002) Transurethral prostatic tissue ablation via a single needle delivery system: initial experience with radio-frequency energy and ethanol. Prostate Cancer Prostatic Dis 5:183–188

    Article  PubMed  CAS  Google Scholar 

  14. Ditrolio J, Patel R, Watson RA et al (2002) Chemo-ablation of the prostate with dehydrated alcohol for the treatment of prostatic obstruction. J Urol 167:2100–2104

    Article  PubMed  CAS  Google Scholar 

  15. Plante M, Anderson R, Badlani G et al (2003) Transurethral ethanol ablation of the prostate using local anesthesia. J Endourol 17(Suppl 1):A158

    Google Scholar 

  16. Gutierrez J, Di Grazia R, Favela R et al (2003) Transurethral ethanol ablation of the prostate, can it be performed under local anesthesia? J Endourol 17(Suppl 1):A159

    Google Scholar 

  17. Grise P, Plante M, Palmer J et al (2004) Evaluation of the transurethral ethanol ablation of the prostate (TEAP) for symptomatic benign prostatic hyperplasia (BPH): a European multi-center evaluation. Eur Urol 46:496–502

    PubMed  CAS  Google Scholar 

  18. Plante MK, Marks LS, Anderson R et al (2007) Phase I/II examination of transurethral ethanol ablation of the prostate for the treatment of symptomatic benign prostatic hyperplasia. J Urol 177:1030–1035

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Carlo Magno.

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Magno, C., Mucciardi, G., Galì, A. et al. Transurethral ethanol ablation of the prostate (TEAP): an effective minimally invasive treatment alternative to traditional surgery for symptomatic benign prostatic hyperplasia (BPH) in high-risk comorbidity patients. Int Urol Nephrol 40, 941–946 (2008). https://doi.org/10.1007/s11255-008-9394-z

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  • DOI: https://doi.org/10.1007/s11255-008-9394-z

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