Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Apr;11(2):271-279.
doi: 10.1016/j.ajur.2023.07.001. Epub 2023 Jul 11.

Transperineal laser ablation of the prostate as a treatment for benign prostatic hyperplasia and prostate cancer: The results of a Delphi consensus project

Andrea Cocci  1 , Marta Pezzoli  2 , Fernando Bianco  3 , Franco Blefari  4 , Pierluigi Bove  5   6 , Francois Cornud  7 , Gaetano De Rienzo  8 , Paolo Destefanis  9 , Danilo Di Trapani  10 , Alessandro Giacobbe  11 , Luca Giovanessi  12 , Antonino Laganà  13 , Giovanni Lughezzani  14   15 , Guglielmo Manenti  16   17 , Gianluca Muto  1 , Gianluigi Patelli  18 , Novello Pinzi  19 , Stefano Regusci  20   21 , Giorgio I Russo  22 , Juan I M Salamanca  23   24 , Matteo Salvi  1 , Luigi Silvestri  25 , Fabrizio Verweij  26 , Eric Walser  27 , Riccardo G Bertolo  6   28 , Valerio Iacovelli  6 , Alessandro Bertaccini  29 , Debora Marchiori  29 , Hugo Davila  30   31 , Pasquale Ditonno  8 , Paolo Gontero  32 , Gennaro Iapicca  33 , Theo M De Reijke  34 , Vito Ricapito  35 , Pierluca Pellegrini  25 , Andrea Minervini  1 , Sergio Serni  1 , Francesco Sessa  1
Affiliations

Transperineal laser ablation of the prostate as a treatment for benign prostatic hyperplasia and prostate cancer: The results of a Delphi consensus project

Andrea Cocci et al. Asian J Urol. 2024 Apr.

Abstract

Objective: To evaluate transperineal laser ablation (TPLA) with Echolaser® (Echolaser® TPLA, Elesta S.p.A., Calenzano, Italy) as a treatment for benign prostatic hyperplasia (BPH) and prostate cancer (PCa) using the Delphi consensus method.

Methods: Italian and international experts on BPH and PCa participated in a collaborative consensus project. During two rounds, they expressed their opinions on Echolaser® TPLA for the treatment of BPH and PCa answering online questionnaires on indications, methodology, and potential complications of this technology. Level of agreement or disagreement to reach consensus was set at 75%. If the consensus was not achieved, questions were modified after each round. A final round was performed during an online meeting, in which results were discussed and finalized.

Results: Thirty-two out of forty invited experts participated and consensus was reached on all topics. Agreement was achieved on recommending Echolaser® TPLA as a treatment of BPH in patients with ample range of prostate volume, from <40 mL (80%) to >80 mL (80%), comorbidities (100%), antiplatelet or anticoagulant treatment (96%), indwelling catheter (77%), and strong will of preserving ejaculatory function (100%). Majority of respondents agreed that Echolaser® TPLA is a potential option for the treatment of localized PCa (78%) and recommended it for low-risk PCa (90%). During the final round, experts concluded that it can be used for intermediate-risk PCa and it should be proposed as an effective alternative to radical prostatectomy for patients with strong will of avoiding urinary incontinence and sexual dysfunction. Almost all participants agreed that the transperineal approach of this organ-sparing technique is safer than transrectal and transurethral approaches typical of other techniques (97% of agreement among experts). Pre-procedural assessment, technical aspects, post-procedural catheterization, pharmacological therapy, and expected outcomes were discussed, leading to statements and recommendations.

Conclusion: Echolaser® TPLA is a safe and effective procedure that treats BPH and localized PCa with satisfactory functional and sexual outcomes.

Keywords: Benign prostatic hyperplasia; Delphi consensus; Prostate cancer; Transperineal laser ablation.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow-chart selection for studies on TPLA for the treatment of benign prostatic hyperplasia or benign prostatic obstruction (on the left) and prostate cancer (on the right). TPLA, transperineal laser ablation.
See this image and copyright information in PMC

References

    1. Manenti G., Perretta T., Calcagni A., Ferrari D., Ryan C.P., Fraioli F., et al. 3-T MRI and clinical validation of ultrasound-guided transperineal laser ablation of benign prostatic hyperplasia. Eur Radiol Exp. 2021;5:41. doi: 10.1186/s41747-021-00239-9. - DOI - PMC - PubMed
    1. van Riel L.A., van Kollenburg R.A.A., Vis A.N., van Leeuwen P.J., de Reijke T.M., de Bruin D.M., et al. Safety and feasibility of Soractelite transperineal focal laser ablation for prostate cancer and short-term quality of life analysis from a multicenter pilot study. Eur Urol Open Sci. 2022;39:48–54. - PMC - PubMed
    1. Sessa F., Polverino P., Siena G., Bisegna C., Lo Re M., Spatafora P., et al. Transperineal laser ablation of the prostate (TPLA) for lower urinary tract symptoms due to benign prostatic obstruction. J Clin Med. 2023;12:793. doi: 10.3390/jcm12030793. - DOI - PMC - PubMed
    1. Sessa F., Polverino P., Bisegna C., Siena G., Lo Re M., Spatafora P., et al. Transperineal laser ablation of the prostate with EchoLaserTM system: perioperative and short-term functional and sexual outcomes. Front Urol. 2022;2:969208. doi: 10.3389/fruro.2022.969208. - DOI
    1. Pacella C.M., Patelli G., Iapicca G., Manenti G., Perretta T., Ryan C.P., et al. Transperineal laser ablation for percutaneous treatment of benign prostatic hyperplasia: a feasibility study. Results at 6 and 12 months from a retrospective multi-centric study. Prostate Cancer Prostatic Dis. 2020;23:356–363. - PubMed

LinkOut - more resources