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Abstract：
OBJECTIVE: Transperineal laser ablation (TPLA) is a new minimally-invasive surgical treatment for patients with benign prostatic obstruction (BPO). We report the perioperative and mid-term functional results of the first 100 consecutively patients undergoing TPLA at our institution.
METHODS: Clinical data from consecutive patients undergoing TPLA at our institution from April 2021 to July 2023 were prospectively collected. Primary endpoints were the postoperative changes in IPSS, QoL and MSHQ 3-item questionnaires and in Qmax and post-void residual volume (PVR).
RESULTS: Overall, 100 consecutive patients underwent the procedure. Median age and prostate volume were 66 (IQR 60-75) years and 50 (IQR 40-70) ml, respectively. In the cohort, 14 (14%) patients had an indwelling catheter and 81 (81%) were under oral BPO therapy at the time of TPLA. Baseline median Qmax (ml/s) and PVR (ml) were 9.1 (IQR 6.9-12) and 90 (IQR 50-150), respectively, while median IPSS and QoL were 18 (IQR 15-23) and 4 (IQR 3-4). At all the follow-up timepoints, the evaluated outcomes on both symptoms and functional parameters showed a statistically significant improvement (p < 0.001). Antegrade ejaculation was preserved in all sexually active patients. No postoperative Clavien-Dindo > 2 complications were recorded.
CONCLUSIONS: TPLA represents a safe option for selected well-informed patients swith LUTS due to BPO. Our prospective study confirms the feasibility and favorable perioperative and functional outcomes in a real-world cohort with heterogenous prostate volumes and patient characteristics.
METHODS: Clinical data from consecutive patients undergoing TPLA at our institution from April 2021 to July 2023 were prospectively collected. Primary endpoints were the postoperative changes in IPSS, QoL and MSHQ 3-item questionnaires and in Qmax and post-void residual volume (PVR).
RESULTS: Overall, 100 consecutive patients underwent the procedure. Median age and prostate volume were 66 (IQR 60-75) years and 50 (IQR 40-70) ml, respectively. In the cohort, 14 (14%) patients had an indwelling catheter and 81 (81%) were under oral BPO therapy at the time of TPLA. Baseline median Qmax (ml/s) and PVR (ml) were 9.1 (IQR 6.9-12) and 90 (IQR 50-150), respectively, while median IPSS and QoL were 18 (IQR 15-23) and 4 (IQR 3-4). At all the follow-up timepoints, the evaluated outcomes on both symptoms and functional parameters showed a statistically significant improvement (p < 0.001). Antegrade ejaculation was preserved in all sexually active patients. No postoperative Clavien-Dindo > 2 complications were recorded.
CONCLUSIONS: TPLA represents a safe option for selected well-informed patients swith LUTS due to BPO. Our prospective study confirms the feasibility and favorable perioperative and functional outcomes in a real-world cohort with heterogenous prostate volumes and patient characteristics.
摘要：
目的：经会阴激光消融（TPLA）是良性前列腺梗阻（BPO）患者的一种新的微创手术治疗方法。我们报告了在我们机构连续接受TPLA的前100名患者的围手术期和中期功能结果。
方法：前瞻性收集了2021年4月至2023年7月在我们机构接受TPLA的连续患者的临床数据。主要终点是术后IPSS的变化，QoL和MSHQ3项问卷以及Qmax和无效剩余量(PVR)。
结果：总体而言，连续100名患者接受了手术。中位年龄和前列腺体积分别为66（IQR60-75）岁和50（IQR40-70）ml，分别。在队列中，14例（14%）患者有留置导尿管，81例（81%）患者在TPLA时接受口服BPO治疗。基线中位数Qmax（ml/s）和PVR（ml）分别为9.1（IQR6.9-12）和90（IQR50-150），分别,而中位数IPSS和QoL分别为18（IQR15-23）和4（IQR3-4）。在所有随访时间点，症状和功能参数的评估结果均显示有统计学意义的改善(p<0.001).所有性活跃患者均保留了顺行射精。没有记录到术后Clavien-Dindo>2的并发症。
结论：TPLA是一个安全的选择，适用于因BPO导致的LUTS患者。我们的前瞻性研究证实了在具有异质性前列腺体积和患者特征的真实世界队列中的可行性和良好的围手术期和功能结局。
方法：前瞻性收集了2021年4月至2023年7月在我们机构接受TPLA的连续患者的临床数据。主要终点是术后IPSS的变化，QoL和MSHQ3项问卷以及Qmax和无效剩余量(PVR)。
结果：总体而言，连续100名患者接受了手术。中位年龄和前列腺体积分别为66（IQR60-75）岁和50（IQR40-70）ml，分别。在队列中，14例（14%）患者有留置导尿管，81例（81%）患者在TPLA时接受口服BPO治疗。基线中位数Qmax（ml/s）和PVR（ml）分别为9.1（IQR6.9-12）和90（IQR50-150），分别,而中位数IPSS和QoL分别为18（IQR15-23）和4（IQR3-4）。在所有随访时间点，症状和功能参数的评估结果均显示有统计学意义的改善(p<0.001).所有性活跃患者均保留了顺行射精。没有记录到术后Clavien-Dindo>2的并发症。
结论：TPLA是一个安全的选择，适用于因BPO导致的LUTS患者。我们的前瞻性研究证实了在具有异质性前列腺体积和患者特征的真实世界队列中的可行性和良好的围手术期和功能结局。
