A Case Series on the Efficacy and Safety of Transperineal Laser Ablation for Benign Prostatic Hyperplasia

TL;DR

This study shows that a minimally invasive laser treatment for enlarged prostate improves symptoms with little recovery time and no sexual side effects.

Contribution

The study provides early evidence on the safety and efficacy of EchoLaser TPLA as a minimally invasive BPH treatment.

Findings

Significant improvements in urinary symptoms and quality of life were observed at 1 month and maintained for 12 months.

The procedure caused minimal pain and had no significant impact on sexual function or PSA levels.

Prostate volume reductions were significant at 6 months but not at 12 months.

Abstract

Background/Objectives: Traditional surgeries for benign prostatic hyperplasia (BPH), such as transurethral resection of the prostate (TURP), carry risks including sexual dysfunction and extended recovery. EchoLaser transperineal laser ablation (TPLA) offers a minimally invasive alternative with potential benefits in preserving sexual function and reducing recovery time. This exploratory study evaluated the safety and efficacy of EchoLaser TPLA for the treatment of prostate-related voiding symptoms. Methods: This retrospective, single-center study enrolled seven patients with lower urinary tract symptoms due to BPH. TPLA was performed under local anesthesia, and follow-up was conducted at 1, 3, 6, and 12 months. The primary outcome was measured by the International Prostate Symptom Score (IPSS). Secondary outcomes included PSA levels, prostate and transition zone (TZ) volume, Qmax, post-void residual (PVR) volume, quality of life (QoL) score, Sexual Health Inventory for Men (SHIM) score, and Male Sexual Health Questionnaire to assess for ejaculatory dysfunction (MSHQ-EjD) score. Results: Statistically significant improvements in IPSS, Qmax, PVR, and QoL relative to baseline were observed at 1 month post-treatment, and these improvements remained significant throughout the 12-month follow-up period. Post-treatment reductions in PV and TZ volume were statistically significant at 6 months; while PV was further reduced at 12 months, this change lacked statistical significance. No statistically significant post-treatment changes were observed in SHIM, MSHQ-EjD 3-Item or Bother scores, or PSA. Mean pain score on the 10-point visual analog scale for procedural pain was 2.14 ± 0.69. Conclusions: Although limited by a lack of generalizability, our findings are consistent with previous studies that have shown EchoLaser TPLA to be a safe and effective in-office treatment for prostate-related voiding symptoms, with minimal discomfort and negligible impact on sexual function. Further studies with larger cohorts and extended follow-up are needed.

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