Category: BPH/LUTS: Electrosurgery, Lasers & Other Technology

MP6-18 - Ultrasound-Guided Transperineal Laser Ablation: a novel modality for the treatment of benign prostatic hyperplasia.

Fri, Sep 21
10:00 AM - 12:00 PM

Introduction & Objective : Over the last decade, there has been effort to identify new technologies aimed at a minimally invasive and rapid therapy for patient affected by symptomatic Benign Prostatic Hyperplasia. The aim of the authors is to evaluate the safety and efficacy of the ultrasound guided Transperineal Laser Ablation (TPLA) in the treatment of Benign Prostatic Hyperplasia (BPH).


Methods :

67 patients (age 73.1 ± 10.7 years, range 51-93) suffering from obstructive syndrome secondary to BPH, (28/67 patients urinary catheter carrier), were treated  with TPLA using continuous wave (CW) diode laser source operating at 1064 nm wavelength. By ultrasound guided transperineal approach, depending on the glandular volume, up to two fibres through 21 G needles for each lobe,  were inserted in the prostate. Each treatment were performed with a standard protocol (3W power with maximum 1,800J delivery for each fibre illumination and eventually pull back) according to the prostate volume. The efficacy of the treatment was evaluated considering the changes of International prostate Symptoms Score (IPSS), the Quality of Life score (QoL), Post-Void Residual (PVR) urine, peak urinary flow rate (Qmax) and prostatic volume. The mean hospital stay and mean catheterization time were measured.


Results :

All 67 patients were treated without procedural complications. The mean operation time was 40.3 ± 7.4 minutes, mean ablation time 15,9 ± 3.9 minutes, mean energy deployed 10,746.3 ± 4,033.3 J, mean hospital time 1.5 ± 0.4 days, mean catheterization time after the procedure was 24.2 ± 14.6 days. Mean follow up was 14 months (range 3-39 months). IPSS improved from 22.3 to 7.7 (P < 0.001), QoL from 4.4 to 0.8 (p < 0.001), Qmax from 9.2 to 12.1 ml/sec (p = 0.001), PVR from 151.7 to 30.2 ml (p < 0,001), prostatic volume from 74.7 to 49.5 ml (p < 0,001). No major complications occurred


Conclusions : TPLA is a novel option to treat patients affected by BPH. This approach was efficacious and safe with significant and durable results.

Gianluigi Patelli

Director of Department of Diagnostic and Interventional Radiology
ASST Bergamo Est – via Paderno 21– 24022 Seriate/Italy
Seriate, Lombardia, Italy

Giovanni Aurelio Paganelli

Urologist
ASST Bergamo Est – via Paderno 21 – 24022 Seriate/Italy
Seriate, Lombardia, Italy

Albani Antonio Piazzini

Surgeon
ASST Bergamo Est – via Paderno 18 – 24022 Seriate/Italy
Seriate, Lombardia, Italy

Stefano Regusci

Urologist
Swiss International Prostate Center – Clinique La Colline – Groupe Hirslanden – avenue Beau-Sejour 6, 1206 Geneva – Switzerland
Geneve, Geneve, Switzerland

Martina Martins

Radiologist
Swiss International Prostate Center – Clinique La Colline – Groupe Hirslanden – avenue Beau-Sejour 6, 1206 Geneva – Switzerland
Geneve, Geneve, Switzerland

Fabiana Codazzi

Diagnostic and Interventional Radiologist
ASST Bergamo Est – via Paderno 21 – 24022 Seriate/Italy
Seriate, Lombardia, Italy

Antioco Pilisiu

Diagnostic and Interventional Radiologist
ASST Bergamo Est – via Paderno 21 – 24022 Seriate/Italy
Seriate, Lombardia, Italy

Giovanni Mauri

Interventional Radiologist
Istituto Europeo di Oncologia – via Ripamonti 435 - 20141 Milano/Italy
Milano, Lombardia, Italy

Claudio Maurizio Pacella

Interventional Radiologist
Regina Apostolorum Hospital, 00041 Albano Laziale /Italy
roma, Lazio, Italy