Objective:

To investigate the clinical application value of transrectal ultrasound-guided transperineal laser ablation (TPLA) in the treatment of benign prostatic hyperplasia (BPH).

Methods:

The size of the prostate was assessed by transrectal biplanar ultrasound imaging. The localization and placement of the laser fiber were monitored

and the ablation process was observed by transrectal ultrasound ima

ges in real time during the treatment process. The laser fiber was introduced through the perineal route to the enlarged prostate tissue beside the urethra

and the safe distance between the fiber and the urethra or neck of the bladder was measured. Continuous bladder and urethral irrigation were performed with room temperature physiological saline through three- chamber urethral catheters. The efficacy and safety of TPLA in treating BPH were initially observed after surgery.

Results:

Irregular ellipsoidal ablation areas were formed in the prostate after TPLA

which were absorbed and shrunk until disappeared during the follow-up. Two patients were followed up 15 and 8 months after TPLA

respectively. The international prostate symptom score (IPSS) decreased from severe to mild

the maximum urine flow rate (Qmax) increased from less than 15 mL/s preoperatively to more than 20 mL/s

the residual urine volume (RUV) decreased by 90% and 70%

respectively

and the quality of life was significantly improved. The prostatic volume reduction rates were 50.6% and 29.1%

respectively

at the last follow-up. The patients suffered less

recovered quickly and had no obvious complications.

Conclusion:

TPLA is a reliable treatment technique with little urethral injury. It has the potential to be a new clinical technique for the treatment of BPH.