Comparison of Single Fiber Transperineal Laser Ablation and Radiofrequency Ablation in the Treatment of Benign Prostatic Hyperplasia.

PURPOSE: To compare the efficacy, safety and operational efficiency of transperineal radiofrequency ablation (TPRFA) and single fiber transperineal laser ablation (TPLA) in patients with benign prostatic hyperplasia (BPH).

MATERIALS AND

METHODS

Patients with moderate to severe lower urinary tract symptoms were included and divided into TPRFA and TPLA groups. Changes in International Prostate Symptom Score (IPSS), quality of life (QoL), prostate volume (PV), post-void residual (PVR), and peak urine flow rate (Qmax) at 6 and 12 months were analyzed and compared between the two groups. Postoperative complications, operation time, ablation time were compared between the two groups.

RESULTS

Thirty-six patients (20 TPRFA vs 16 TPLA) were analyzed. At 12 months, the between-group difference in change in IPSS, QoL, PV, Qmax and PVR from baseline was - 1.59 (95% CI: - 5.12 to 1.94, p = 0.37), 0.16 (95% CI: - 0.39 to 0.70, p = 0.57), - 5.00 (95% CI: - 10.41 to 0.41, p = 0.07), - 0.10 (95% CI: - 3.52 to 3.32, p = 0.95), - 6.40 (95% CI: - 93.30 to 81.09, p = 0.88). The TPRFA group had significantly shorter operation time and ablation time than the TPLA group (p < 0.001). Complication rates were similar in both groups (20% in TPRFA and 25% in TPLA, p = 0.740), mainly urinary retention.

CONCLUSION

Both TPRFA and TPLA effectively improved lower urinary tract symptoms in BPH patients, with no significant statistical difference in therapeutic efficacy observed at 12 months post-procedure. TPRFA was associated with a shorter operation time and ablation time, which may make it a new option for BPH treatment.

LEVEL OF EVIDENCE: Level 3b, Retrospective Cohort Study.