Patelli Gianluigi, Ranieri Antonio, Paganelli Aurelio, Mauri Giovanni, Pacella Claudio Maurizio
Department of Interventional Radiology, Pesenti-Fenaroli Hospital-ASST Bergamo Est, 24022, Alzano Lombardo, Italy.
Department of Urology, Pesenti-Fenaroli Hospital-ASST Bergamo Est, 24022, Alzano Lombardo, Italy.
Cardiovasc Intervent Radiol. 2017 Sep;40(9):1440-1446. doi: 10.1007/s00270-017-1662-9. Epub 2017 May 4.
To assess the feasibility and safety of transperineal laser ablation (TPLA) for treating benign prostatic hyperplasia (BPH).
Institutional review board approval was obtained for this prospective non-randomized trial. Eightteen patients (age 71.7 ± 9.4 years) with urinary symptoms secondary to BPH underwent TPLA under local anesthesia. Under US guidance, up to four 21G applicators were inserted in the prostatic tissue. Each treatment was performed with diode laser operating at 1064 nm changing the illumination time according to prostate size. Primary endpoints were technical success and safety of TPLA. Secondary endpoints included operation time, ablation time, energy deployed, hospitalization time, catheterization time, and change in International Prostate Symptom Score (IPSS), Quality of Life (QoL), peak urinary flow rate (Q ), post-void residual (PVR), and prostatic volume at 3 months. χ and Fisher exact tests were used.
All procedures were technically successful. No complications occurred. Mean operation time was 43.3 ± 8.7 min, mean ablation time 15.9 ± 3.9 min, mean energy deployed 10,522 ± 3290.5 J, mean hospital stay 1.5 ± 0.4 days, and mean catheterization time 17.3 ± 10.0 days. At 3 months, IPSS improved from 21.9 to 10.7 (P < 0.001), QoL from 4.7 ± 0.6 to 2.1 ± 1.2 (P < 0.001), Q from 7.6 to 13.3 mL/s (P = 0.001), PVR from 199.9 ± 147.3 to 81.5 ± 97.8 (P < 0.001), and mean prostate volume from 69.8 to 54.8 mL (P < 0.001).
TPLA is feasible and safe in the treatment of BPH, providing significant clinical results at 3 months.
Case series, Level IV.
评估经会阴激光消融术（TPLA）治疗良性前列腺增生（BPH）的可行性和安全性。
本前瞻性非随机试验获得了机构审查委员会的批准。18例因BPH继发尿路症状的患者（年龄71.7±9.4岁）在局部麻醉下接受了TPLA治疗。在超声引导下，将多达4根21G穿刺针插入前列腺组织。每次治疗使用波长为1064nm的二极管激光，根据前列腺大小改变照射时间。主要终点是TPLA的技术成功率和安全性。次要终点包括手术时间、消融时间、能量使用量、住院时间、导尿时间，以及3个月时国际前列腺症状评分（IPSS）、生活质量（QoL）、最大尿流率（Q）、残余尿量（PVR）和前列腺体积的变化。采用χ²检验和Fisher精确检验。
所有手术在技术上均获成功。未发生并发症。平均手术时间为43.3±8.7分钟，平均消融时间为15.9±3.9分钟，平均能量使用量为10522±3290.5焦耳，平均住院时间为1.5±0.4天，平均导尿时间为17.3±10.0天。3个月时，IPSS从21.9改善至10.7（P<0.001），QoL从4.7±0.6改善至2.1±1.2（P<0.001），Q从7.6增至13.3毫升/秒（P=0.001），PVR从199.9±147.3降至81.5±97.8（P<0.001），平均前列腺体积从69.8毫升降至54.8毫升（P<0.001）。
TPLA治疗BPH可行且安全，在3个月时可取得显著临床效果。
病例系列，IV级。
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