Abstract
We report an initial clinical experience to evaluate the safety and efficacy of outpatient prostatic ablation for the treatment of symptomatic benign prostatic hyperplasia (BPH) using local anesthesia (OPAL®) with radio-frequency energy and intraprostatic absolute ethanol injection (EI). Twenty-three patients were treated with OPAL® and five patients were treated with EI. Pre-operative data for all patients included international prostate symptom score (IPSS), quality of life score (QL), maximum flow rate (Qmax), and post void residual determination. Prostate specific antigen (PSA) and transrectal ultrasound prostate volume determination were also done for EI patients. Needle deployment into the prostate was carried out at the 2, 4, 8 and 10 o'clock positions for lateral lobe hyperplasia and the 6 o'clock position for middle lobe hyperplasia. IPSS, QL, Qmax and post void residual data were collected at 1, 3, 6 and 12 months post procedure. Both procedures resulted in statistically significant reductions of IPSS and QL. Trends towards improvement were seen both for Qmax and post void residual, with Qmax significantly improved after OPAL®. Among EI patients, the prostate volume was reduced at 6 months post treatment to 37.2±17.9 g from 53.0±19.0 g (P=0.03) preoperatively. OPAL® was safe but suffered from a high re-treatment rate. EI demonstrated encouraging results with regards to safety, symptom improvement and prostate volume reduction.
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Acknowledgements
The authors would like to thank Sharon Little, LPN for her clinical support and Jody Ciano for her editorial assistance. Prosurg, Inc. provided the OPAL® probes and impedence monitor used in the study.
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Plante, M., Bunnell, M., Trotter, S. et al. Transurethral prostatic tissue ablation via a single needle delivery system: initial experience with radio-frequency energy and ethanol. Prostate Cancer Prostatic Dis 5, 183–188 (2002). https://doi.org/10.1038/sj.pcan.4500583
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DOI: https://doi.org/10.1038/sj.pcan.4500583
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