Diagnostic and interventional radiology (Ankara, Turkey) · 2026
Image-guided, urethra-sparing transperineal radiofrequency ablation for benign prostatic hyperplasia: a prospective bicenter outpatient study.
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Nunes Thiago Franchi, Szejnfeld Denis, Viana Públio Cesar Cavalcante, Stefanini Flávio Scavone, Fornazari Vinicius Adami Vayego, Leite Túlio Fabiano de Oliveira, Sarkis Alvaro Sadek, Castro Hugo Alexandre Socrates de
Аннотация
PURPOSE: To evaluate the feasibility, reproducibility, and clinical outcomes of an image-guided, urethra-sparing transperineal radiofrequency ablation (TPTA) strategy for benign prostatic hyperplasia (BPH) in an outpatient interventional radiology setting.
METHODS: This was a prospective, bicenter, non-randomized study of consecutive men with moderate-to-severe lower urinary tract symptoms (LUTS) refractory or intolerant to medication treated with ultrasound-guided, urethra-sparing TPTA. Outcomes included the International Prostate Symptom Score (IPSS), quality of life, maximum urinary flow rate (Qmax), post-void residual volume (PVR), prostate volume, prostate-specific antigen (PSA), and ejaculatory function [assessed using the Male Sexual Health Questionnaire-Ejaculatory Dysfunction Short Form (MSHQ-EjD-SF)]; complications were graded using the Clavien-Dindo classification. The primary endpoint was a 12-month change in ejaculatory function; secondary endpoints included composite clinical response (≥ 30% IPSS reduction without retreatment) and urinary and structural changes.
RESULTS: At 12 months, clinically meaningful improvements were observed across patient-reported symptoms and concordant objective functional and anatomical parameters in a carefully selected outpatient cohort. The median IPSS decreased from 19.5 at baseline to 5.0 at 6 months and 4.0 at 12 months (P < 0.001), accompanied by sustained increases in the Qmax and reductions in PVR, prostate volume, and PSA (all P < 0.001). Among sexually active men, MSHQ-EjD-SF function scores remained stable during the follow-up period, and antegrade ejaculation was preserved in 90% of patients. The composite clinical response rate (≥ 30% IPSS reduction without retreatment) was 97.1% at both 6 and 12 months, with no device-related Clavien-Dindo ≥ III complications observed.
CONCLUSION: These findings suggest that image-guided, urethra-sparing TPTA is a reproducible outpatient interventional radiology procedure capable of achieving clinically meaningful symptom relief while preserving ejaculatory function, supporting further comparative and multicenter evaluation.
CLINICAL SIGNIFICANCE: Urethra-sparing TPTA has proven to be a safe, feasible, and effective treatment for LUTS and may represent a minimally invasive and effective alternative for BPH.
METHODS: This was a prospective, bicenter, non-randomized study of consecutive men with moderate-to-severe lower urinary tract symptoms (LUTS) refractory or intolerant to medication treated with ultrasound-guided, urethra-sparing TPTA. Outcomes included the International Prostate Symptom Score (IPSS), quality of life, maximum urinary flow rate (Qmax), post-void residual volume (PVR), prostate volume, prostate-specific antigen (PSA), and ejaculatory function [assessed using the Male Sexual Health Questionnaire-Ejaculatory Dysfunction Short Form (MSHQ-EjD-SF)]; complications were graded using the Clavien-Dindo classification. The primary endpoint was a 12-month change in ejaculatory function; secondary endpoints included composite clinical response (≥ 30% IPSS reduction without retreatment) and urinary and structural changes.
RESULTS: At 12 months, clinically meaningful improvements were observed across patient-reported symptoms and concordant objective functional and anatomical parameters in a carefully selected outpatient cohort. The median IPSS decreased from 19.5 at baseline to 5.0 at 6 months and 4.0 at 12 months (P < 0.001), accompanied by sustained increases in the Qmax and reductions in PVR, prostate volume, and PSA (all P < 0.001). Among sexually active men, MSHQ-EjD-SF function scores remained stable during the follow-up period, and antegrade ejaculation was preserved in 90% of patients. The composite clinical response rate (≥ 30% IPSS reduction without retreatment) was 97.1% at both 6 and 12 months, with no device-related Clavien-Dindo ≥ III complications observed.
CONCLUSION: These findings suggest that image-guided, urethra-sparing TPTA is a reproducible outpatient interventional radiology procedure capable of achieving clinically meaningful symptom relief while preserving ejaculatory function, supporting further comparative and multicenter evaluation.
CLINICAL SIGNIFICANCE: Urethra-sparing TPTA has proven to be a safe, feasible, and effective treatment for LUTS and may represent a minimally invasive and effective alternative for BPH.