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 Jul 10;42(1):402.
doi: 10.1007/s00345-024-05077-z.

Transperineal laser ablation (TPLA) of the prostate for benign prostatic obstruction: the first 100 patients cohort of a prospective, single-center study

Mattia Lo Re  1   2   3 , Paolo Polverino  4   5 , Anna Rivetti  4 , Alessio Pecoraro  4   5 , Marco Saladino  4   5 , Marta Pezzoli  4   5 , Giampaolo Siena  5 , Cosimo De Nunzio  6 , Vincenzo Li Marzi  4 , Mauro Gacci  4 , Sergio Serni  4 , Riccardo Campi  4 , Francesco Sessa  7   8
Affiliations

Transperineal laser ablation (TPLA) of the prostate for benign prostatic obstruction: the first 100 patients cohort of a prospective, single-center study

Mattia Lo Re et al. World J Urol. .

Abstract

Purpose: Transperineal laser ablation (TPLA) is a new minimally-invasive surgical treatment for patients with benign prostatic obstruction (BPO). We report the perioperative and mid-term functional results of the first 100 consecutively patients undergoing TPLA at our institution.

Methods: Clinical data from consecutive patients undergoing TPLA at our institution from April 2021 to July 2023 were prospectively collected. Primary endpoints were the postoperative changes in IPSS, QoL and MSHQ 3-item questionnaires and in Qmax and post-void residual volume (PVR).

Results: Overall, 100 consecutive patients underwent the procedure. Median age and prostate volume were 66 (IQR 60-75) years and 50 (IQR 40-70) ml, respectively. In the cohort, 14 (14%) patients had an indwelling catheter and 81 (81%) were under oral BPO therapy at the time of TPLA. Baseline median Qmax (ml/s) and PVR (ml) were 9.1 (IQR 6.9-12) and 90 (IQR 50-150), respectively, while median IPSS and QoL were 18 (IQR 15-23) and 4 (IQR 3-4). At all the follow-up timepoints, the evaluated outcomes on both symptoms and functional parameters showed a statistically significant improvement (p < 0.001). Antegrade ejaculation was preserved in all sexually active patients. No postoperative Clavien-Dindo > 2 complications were recorded.

Conclusions: TPLA represents a safe option for selected well-informed patients swith LUTS due to BPO. Our prospective study confirms the feasibility and favorable perioperative and functional outcomes in a real-world cohort with heterogenous prostate volumes and patient characteristics.

Keywords: Benign prostatic hyperplasia; Ejaculation sparing; Lower urinary tract symptoms; Transperineal laser ablation of the prostate; Ultra-minimally invasive surgical techniques.

PubMed Disclaimer

Conflict of interest statement

The authors certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript.

Figures

Fig. 1
Fig. 1
Clinical outcomes at 3, 6, 12 months. MSHQ male sexual healt questionnarie 3 items, IPSS International Prostate Symptoms Score, Qmax maximum urinary flow rate, PVR post-void residual, QoL quality of life
See this image and copyright information in PMC

Comment in

References

    1. Martin SA, Haren MT, Marshall VR, Lange K, Wittert GA (2011) Prevalence and factors associated with uncomplicated storage and voiding lower urinary tract symptoms in community-dwelling Australian men. World J Urol 29:179–184 - PubMed
    1. Taub DA, Wei JT (2006) The economics of benign prostatic hyperplasia and lower urinary tract symptoms in the United States. Curr Urol Rep 7:272–281 - PubMed
    1. Gravas S, Cornu JN, Gacci M, Gratzke C, Herrmann TR, Mamoulakis C et al EAU Guidelines on Management of Non-neurogenic Male LUTS. EAU Guidelines. Edn. presented at the EAU Annual Congress Amsterdam 2022. ISBN 978-94-92671-16-5
    1. Elshal AM, Soltan M, El-Tabey NA, Laymon M, Nabeeh A (2020) Randomised trial of bipolar resection vs holmium laser enucleation vs Greenlight laser vapo-enucleation of the prostate for treatment of large benign prostate obstruction: 3-years outcomes. BJU Int 126:731–738 - PubMed
    1. Capogrosso P, Fallara G, Pozzi E, Schifano N, Candela L, Costa A et al (2022) Rates and predictors of postoperative complications after Holmium laser enucleation of the prostate (HoLEP) at a high-volume center. Minerva Urol Nephrol 74:461–466 - PubMed

LinkOut - more resources