TY  - EJOU
AU  - Ruffo, Antonio 
AU  - Esposito, Fabio 
AU  - Altieri, Vincenzo Maria 
AU  - Illiano, Ester 
AU  - Spirito, Lorenzo 
AU  - Santarelli, Valerio 
AU  - Giudice, Francesco Del 
AU  - Crocetto, Felice 
AU  - Barone, Biagio 

TI  - Transperineal laser ablation for high-volume benign prostatic hyperplasia: a prospective study of efficacy and safety
T2  - Canadian Journal of Urology

PY  - 
VL  - 
IS  - 
SN  - 1488-5581

AB  -  <b>Objectives:</b> Transperineal Laser Ablation (TPLA) has emerged as a minimally invasive/ejaculation-sparing alternative to traditional benign prostatic hyperplasia (BPH) surgical treatments. Aim of this study was to evaluate the mid-term outcomes of TPLA in treating patients with high-volume BPH. <b>Methods:</b> This prospective study included 66 patients with large-volume BPH (median volume 95 mL, IQR 78–120). A significant proportion presented with previous acute urinary retention (48.5%), with 28.8% being catheter-dependent preoperatively. All TPLA procedures were performed under local anesthesia. Efficacy was assessed by changes in the International Prostate Symptom Score (IPSS), quality of life index (IQoL), maximum flow rate (Qmax), post-void residual (PVR) volume, and prostate volume from baseline to 3, 6, and 12 months. Statistical analysis utilized non-parametric tests. <b>Results:</b> TPLA demonstrated significant and rapid improvements in all parameters. Median prostate volume reduction was 42.1% at 3 months (55 mL, <i>p</i> &lt; 0.0001) and 57.9% at 12 months (40 mL, <i>p</i> &lt; 0.0001). Symptom burden decreased markedly, with median IPSS improving from 20 (severe) to 6 (mild) at 12 months (<i>p</i> &lt; 0.0001). IQoL scores improved from 4 to 1. Obstructive parameters resolved effectively: Qmax doubled from 8 mL/s to 18 mL/s (<i>p</i> &lt; 0.0001), and median PVR decreased from 80 mL to 0 mL. All patients were free from BPH therapy at 12 months. All preoperatively catheterized patients were successfully decatheterized. The complication rate was low (&lt;10%), with all events being minor (Clavien-Dindo I-II). <b>Conclusion:</b> TPLA is a highly effective, minimally invasive treatment for high-volume BPH, within the limitations of a single-arm study, facilitating substantial tissue reduction and thus leading to significant symptomatic improvement.
KW  - Transperineal Laser Ablation (TPLA); benign prostatic hyperplasia; minimally invasive surgery; high prostate volume; urinary retention

DO  - 10.32604/cju.2026.081080