Abstract

Background

Transperineal laser ablation (TPLA) of the prostate is a novel, mini-invasive option for men with lower urinary tract symptoms (LUTS) due to benign prostate hyperplasia (BPH). Our aim was to assess the impact of ultrasound-guided TPLA regarding urodynamic improvement and sexual function, monitoring clinical data, postprocedural complications and imaging findings at 3-T multiparametric magnetic resonance imaging.

Methods

Forty-four patients aged ≥ 50 affected with moderate to severe LUTS (International Prostate Symptoms score ≥ 12) due to benign prostatic obstruction and refractoriness, intolerance or poor compliance to medical therapies underwent US-guided TPLA between May 2018 and February 2020. Clinical measurements included PSA, uroflowmetry, sexual function assessment (using the International Index of Erectile Function and Male Sexual Health Questionnaire-Ejaculatory Dysfunction short form) and quality of life questionnaire. Adverse events were evaluated using the Clavien-Dindo scale. Volume changes were measured by MRI and automatic segmentation software during 1-year follow-up. Registration: NCT04044573 – May 5th, 2018, https://www.clinicaltrials.gov

Results

MRI assessed the changes over time with a 53% mean reduction of adenoma volume and 71% of the ablated area, associated with clinical and functional improvement and resolution of LUTS in all cases. Five of 44 patients (11.3%) had urinary blockage due to clots and required re-catheterisation for 2 weeks. The overall adverse event rate was 7%.

Conclusion

US-guided TPLA performed as a safe, manageable and effective treatment for LUTS. It could be considered an alternative effective mini-invasive procedure to standard treatments for BPH in the outpatient setting.

Details

Title
3-T MRI and clinical validation of ultrasound-guided transperineal laser ablation of benign prostatic hyperplasia
Author
Manenti Guglielmo 1   VIAFID ORCID Logo  ; Perretta Tommaso 2 ; Calcagni Antonello 2 ; Ferrari Donatella 2 ; Ryan, Colleen P 3 ; Fraioli Federico 2 ; Meucci Rosaria 2 ; Malizia, Andrea 2 ; Iacovelli Valerio 4 ; Agrò, Enrico Finazzi 4 ; Floris, Roberto 1 

 University of Rome “Tor Vergata”, Department of Biomedicine and Prevention, Rome, Italy (GRID:grid.6530.0) (ISNI:0000 0001 2300 0941); University of Rome “Tor Vergata”, Department of Diagnostic Imaging and Interventional Radiology, Rome, Italy (GRID:grid.6530.0) (ISNI:0000 0001 2300 0941) 
 University of Rome “Tor Vergata”, Department of Biomedicine and Prevention, Rome, Italy (GRID:grid.6530.0) (ISNI:0000 0001 2300 0941) 
 Fondazione Santa Lucia IRCCS, Department of Neuromotor Physiology, Rome, Italy (GRID:grid.417778.a) (ISNI:0000 0001 0692 3437) 
 University of Rome “Tor Vergata”, Department of Urology, Rome, Italy (GRID:grid.6530.0) (ISNI:0000 0001 2300 0941) 
Publication year
2021
Publication date
Dec 2021
Publisher
Springer Nature B.V.
e-ISSN
25099280
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2573127516
Copyright
© The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.