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.
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).
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.
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.
World journal of urology. 2024 Jul 10*** epublish ***
Mattia Lo Re, Paolo Polverino, Anna Rivetti, Alessio Pecoraro, Marco Saladino, Marta Pezzoli, Giampaolo Siena, Cosimo De Nunzio, Vincenzo Li Marzi, Mauro Gacci, Sergio Serni, Riccardo Campi, Francesco Sessa
Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, 50100, Italy. ., Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, 50100, Italy., Unit of Oncologic Minimally Invasive Urology and Andrology, University of Florence, Careggi Hospital, Florence, 50100, Italy., Department of Urology, Sant'Andrea Hospital, Sapienza University, Rome, Italy., Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, 50100, Italy. .