Transperineal Laser Ablation of the Prostate for Symptomatic Benign Prostatic Hyperplasia: Long-Term Follow-Up in 40 Patients

Gianluigi Patelli; Vincenzo Maria Altieri; Anna Maria Ierardi; Aldo Carnevale; Federica Chizzoli; Gustavo Baronchelli; Renato Trimarchi; Gianpaolo Carrafiello

doi:10.1016/j.jvir.2024.04.023

Transperineal Laser Ablation of the Prostate for Symptomatic Benign Prostatic Hyperplasia: Long-Term Follow-Up in 40 Patients

J Vasc Interv Radiol. 2024 May 3:S1051-0443(24)00326-9. doi: 10.1016/j.jvir.2024.04.023. Online ahead of print.

Authors

Gianluigi Patelli¹, Vincenzo Maria Altieri², Anna Maria Ierardi³, Aldo Carnevale⁴, Federica Chizzoli⁵, Gustavo Baronchelli⁵, Renato Trimarchi⁵, Gianpaolo Carrafiello³

Affiliations

¹ Radiology Department, ASST Bergamo Est, Seriate, Italy. Electronic address: gianluigi.patelli@asst-bergamoest.it.
² Urology Department, Humanitas Gavazzeni, Bergamo, Italy - Università degli Studi del Molise.
³ Radiology Department, Università Statale degli Studi Di Milano, IRCCS Policlinico, Milano, Italy.
⁴ Department of Translational Medicine, University of Ferrara, Ferrara, Italy.
⁵ Radiology Department, ASST Bergamo Est, Seriate, Italy.

PMID: 38705571
DOI: 10.1016/j.jvir.2024.04.023

Abstract

Purpose: To evaluate the long-term efficacy and safety of proprietary transperineal laser ablation (TPLA) of the prostate.

Materials and methods: Patients with symptomatic benign prostatic hyperplasia underwent TPLA with a 1064-nm continuous-wave diode laser. IPSS, QoL, PVR and prostate volume were evaluated at baseline and successive timepoints.

Results: Forty prospectively enrolled patients had post-TPLA follow-up of ≥ 36 months. Median duration of follow-up was 56.5 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 vs baseline. There were no intraoperative adverse events; perioperative adverse events consisted of one case of prostatitis and one case of urinary tract infection (both mild according to the modified SIR classification system).

Conclusion: TPLA for symptomatic BPH produced durable benefits across a range of clinical outcomes and was well tolerated in 56.5 months median duration follow-up.

Keywords: benign prostatic hyperplasia; interstitial laser ablation; laser therapy; lower urinary tract symptoms; transperineal laser ablation.