There are a number of minimally invasive treatments for men with lower-urinary-tract symptoms (LUTS) resulting from benign prostatic hyperplasia (BPH) or benign prostatic obstruction (BPO).
TPLA uses laser light to cause irreversible necrosis of the cells inside an ellipsoid measuring approximately 22.5 mm in longitudinal diameter and 16 mm in transversal diameter, one-third of which is located behind the tip of the optic fiber and two-thirds of which is located in front of it.
Dr. Gaetano de Rienzo and colleagues of the University of Bari describe their experience with 21 men who underwent TPLA for BPO at their center. The patients' median age was 62 years, and their median prostate volume was 40 mL.
The mean operative time was 36 minutes, and there were no intraoperative complications.
The only significant postoperative complication was a prostatic abscess within the first 30 days, which was treated successfully with percutaneous drainage and antibiotic therapy.
All but one of the 16 patients who had been treated with oral medication had discontinued that medication after one month (the exception was a patient who feared that his symptoms would return, but even he was no longer taking medications at three months).
Maximum urinary-flow rates increased from 9.2 mL/s at baseline to 12.1 mL/s at one month and improved further to 13.9 mL/s by 6 months, the researchers report in European Urology.
Postvoid residual volume improved from 81.8 mL preoperatively to 37.4 mL at one month and 14.0 mL at six months.
Patients also experienced significant improvements in International Prostate Symptom Score, ejaculatory function and quality of life after TPLA.
"TPLA is a simple, feasible procedure able to produce symptomatic and urodynamic improvements durable at one year," the authors conclude. "The reduced invasiveness, the outpatient vocation, and the peculiar ability to preserve ejaculation candidates the procedure to become an intermediate option between medical treatment and surgery."
Dr. de Rienzo did not respond to a request for comments.
By Reuters Staff
SOURCE: https://bit.ly/3jWV4cx European Urology, online August 28, 2020.
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