Mp27-07 Trans-Perineal Laser Ablation of the Prostate for the Treatment of Benign Prostatic Obstruction in High Surgical Risk Patients. One-Year Results From a Prospective Cohort of “Extreme” Patients

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology II (MP27)1 May 2024MP27-07 TRANS-PERINEAL LASER ABLATION OF THE PROSTATE FOR THE TREATMENT OF BENIGN PROSTATIC OBSTRUCTION IN HIGH SURGICAL RISK PATIENTS. ONE-YEAR RESULTS FROM A PROSPECTIVE COHORT OF "EXTREME" PATIENTS Mattia Sibona, Federico Vitiello, Gabriele Montefusco, Eugenia Vercelli, Luca Micai, Francesco M. Bracco, Carlotta Mangione, Fulvia Colucci, Paolo Destefanis, and Paolo Gontero Mattia SibonaMattia Sibona , Federico VitielloFederico Vitiello , Gabriele MontefuscoGabriele Montefusco , Eugenia VercelliEugenia Vercelli , Luca MicaiLuca Micai , Francesco M. BraccoFrancesco M. Bracco , Carlotta MangioneCarlotta Mangione , Fulvia ColucciFulvia Colucci , Paolo DestefanisPaolo Destefanis , and Paolo GonteroPaolo Gontero View All Author Informationhttps://doi.org/10.1097/01.JU.0001009400.86696.a2.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Trans-Perineal Laser Ablation of the prostate (TPLA) is an acknowledged Minimally Invasive Surgical Technique (MIST) for the treatment of Benign Prostatic Obstruction (BPO). It was promisingly proposed for the treatment of both standard or high-risk BPO patients (pts). Short-term results from our prospective cohort of elderly/comorbid pts already suggested efficacy together with a high safety profile. The aim of our study was to report one-year results from the same cohort. METHODS: A full Local Ethics Committee approval was obtained (n. 00161/2020). From 10/2020 to 06/2022, consecutive BPO pts were prospectively enrolled. Inclusion criteria were: 1) ongoing anticoagulant or double antiplatelet therapies or severe non-pharmacological coagulopathies (i.e. low platelet syndromes) or American Society of Anesthesiologists (ASA) score >3 together with 2) moderate to severe LUTS (IPSS>8 and IPSS bother score>=3), maximum flow rate<15 ml/min or indwelling bladder catheter. All patients underwent TPLA under local anesthesia with the SoracteLite® system (Elesta s.r.l., Calenzano, Italy). Baseline, 6 and 12-months follow-up data were recorded. RESULTS: Globally, 40 pts were enrolled. Median (IQR) age was 80 (72.5-84) years. 23/40 (57.5%) pts were chronic catheter carriers. Median Charlson Comorbidity Index was 6 (5-7). Median prostate volume was 38 (30.5-73) cc. A TPLA procedure was performed in all pts, without intraoperative complications. Within 3 months from surgery, we reported 19 complications (47.5%). According to the Clavien- Dindo classification, 13 were grade I (32.5%), 5 grade II (12.5%), 1 grade III (2.5%, endoscopic re-intervention for hematuria). We did not report any grade IV-V complications. After 6 months, the median IPSS score decreased from 25 (19-30) to 8 (6-11.5), p=0.001. A chronic bladder catheter was successfully removed in 13/23 pts (56.5%). After 1 year, 9 pts were reported dead for non- urological causes (22.5%); 3 pts (7.5%) underwent further surgery for persistent obstruction. 5 pts (12.5%) were still chronic bladder carriers. However, a persistent benefit from the intervention was reported in 23/40 pts (57.5%), with similar IPSS scores compared to the 6-months results. CONCLUSIONS: Elderly men with severe comorbidities have few chances of treatment of BPO. In these cases, TPLA can be a safe alternative. The efficacy of the procedure varies among patients, with a persistent benefit detectable in 50% of them after one year. An accurate candidate selection is mandatory to optimize surgical outcomes. Source of Funding: There were not source of funding © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e425 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Mattia Sibona More articles by this author Federico Vitiello More articles by this author Gabriele Montefusco More articles by this author Eugenia Vercelli More articles by this author Luca Micai More articles by this author Francesco M. Bracco More articles by this author Carlotta Mangione More articles by this author Fulvia Colucci More articles by this author Paolo Destefanis More articles by this author Paolo Gontero More articles by this author Expand All Advertisement PDF downloadLoading ...