Minimally invasive transperineal laser ablation of the prostate appears effective

Minimally invasive transperineal laser ablation (TPLA) of the prostate appears effective for benign prostatic hyperplasia (BPH), according to a review published online Sept. 21 in Therapeutic Advances in Urology.

Lazaros Tzelves, from the University College London Hospitals, and colleagues conducted a systematic literature review to examine the safety and efficacy of TPLA for BPH.

Based on 11 included studies, the researchers found that functional outcomes were improved in the majority of studies both for objective (maximum flow rate and postvoid residual) and subjective outcomes (improvement of International Prostate Symptom Score and quality of life). Complications included hematuria (range: 1.9 to 2.3 percent), dysuria (3.7 to 36.3 percent), acute urinary retention (1.9 to 19 percent), orchitis/urinary tract infections (0.6 to 9.1 percent), and prostatic abscess formation (0.6 to 4.8 percent). The vast majority of patients (>95 percent) retained their ejaculation, while erectile function was maintained or improved.

"TPLA of the prostate is an innovative, minimally invasive technique for managing patients with BPH," the authors write. "Existing studies indicate an effective technique in reducing International Prostate Symptom Score and quality of life scores, postvoid residual reduction, and increase in Qmax [maximum urinary flow rate], albeit the measured improvements in terms of Qmax are not equal to transurethral resection of the prostate."