Transperineal Laser Ablation of the Prostate for Symptomatic Benign Prostatic Hyperplasia: Long-Term Follow-Up in 40 Patients

Purpose To evaluate the long-term efficacy and safety of proprietary transperineal laser ablation (TPLA) of the prostate. Materials and Methods Patients with symptomatic benign prostatic hyperplasia underwent TPLA with a 1064-nm continuous-wave diode laser. IPSS, QoL, PVR and prostate volume were evaluated at baseline and successive timepoints. Results Forty prospectively enrolled patients had post-TPLA follow-up of ≥ 36 months. Median duration of follow-up was 56.5 months (range: 36−76 months). Compared with baseline, the median reduction in IPSS at 12-month follow-up was 74% (interquartile range [IQR]: 60−81%) (P < .001). Median QoL score at 12 months was improved from 5 (IQR: 4−5) at baseline to 1 (IQR: 0−1) (P < .001). Median PVR at 12 months decreased from 108 mL (IQR: 38−178 mL) to 13.5 mL (IQR: 0−40.5 mL) (P < .001), a median reduction of 88% (IQR: 61−100%). At 12 months, median prostate volume was significantly reduced from 66 mL (IQR: 48.5−86.5 mL) to 46 mL (IQR 36−65 mL) (P < .001), a median reduction of 32% (IQR: 21–45%). For all of these parameters, the benefit of TPLA persisted at last follow-up and all changes were statistically significant vs baseline. There were no intraoperative adverse events; perioperative adverse events consisted of one case of prostatitis and one case of urinary tract infection (both mild according to the modified SIR classification system). Conclusion TPLA for symptomatic BPH produced durable benefits across a range of clinical outcomes and was well tolerated in 56.5 months median duration follow-up.