Office-based transperineal laser ablation for benign prostatic hyperplasia: Functional outcomes and predictors of clinical improvement.
- 1University of Florida College of Medicine, Gainesville, Florida, United States of America.
- 2National Medical Association and Research Group / Urologic Integrated Care, Gainesville, Florida, United States of America.
- 3Houston Methodist Hospital, Houston, Texas, United States of America.
Abstract
Introduction
Transperineal laser ablation (TPLA) is an ultrasound-guided, office-based procedure for the treatment of benign prostatic hyperplasia (BPH). This study evaluates short-term functional outcomes following TPLA and identifies predictors of clinical improvement.Material and methods
This cohort included men undergoing TPLA between January 1, 2025, and February 1, 2026, using a transperineal interstitial laser system (EchoLaser, Elesta SpA). Minimum follow-up was 6 months. Variables included age, body mass index (BMI), prostate-specific antigen (PSA), PSA density, testosterone, prostate volume, International Prostate Symptom Score (IPSS), peak urinary flow rate (Qmax), and post-void residual (PVR). Intraoperative variables included ablation time and energy delivered. Pre- and post- treatement differences were assessed using the Wilcoxon signed rank test. Spearman correlation analysis evaluated predictors of improvement.Results
Thirty-five of forty men met the inclusion criteria. Mean prostate volume was 71.6 cm³ (range 29.8-196). Mean IPSS improved from 23.5 to 10.6 (p <0.001). Qmax increased from 7.2 to 18.4 ml/s (p = 0.007). PVR decreased from 396.8 to 70.6 ml (p <0.001). Comorbidities included urinary tract infection or urosepsis history, hypertension, diabetes, hypercholesterolemia, and anticoagulation use. Postoperative complications included three patients with urinary retention requiring catheterization and one patient with urosepsis requiring hospitalization. Greater improvement correlated with higher baseline IPSS and PVR (p <0.001).Conclusions
Office-based TPLA produced significant short term functional improvement. Functional gains were comparable to those achieved with hospital based surgical interventions. Prospective, multicenter, randomized studies are warranted to further evaluate long term durability.
Related
- Image-guided, urethra-sparing transperineal radiofrequency ablation for benign prostatic hyperplasia: a prospective bicenter outpatient study
- Patient and Partner Sexual Outcomes After Transperineal Laser Ablation for Benign Prostatic Hyperplasia: A 12-Month Longitudinal Study
- Two-dimensional computational fluid dynamics study of urine flow in the prostatic fossa after benign prostatic hyperplasia surgery: a single-patient model
- Intake of foods containing phytochemicals is correlated with benign prostatic hyperplasia development: a long-term follow-up study
- Cumulative average glucose–lipid metabolic obesity index associates with benign prostatic hyperplasia incidence in Chinese middle-aged and older men
BibTeX
@article{varela2026officebased,
title = {{Office-based transperineal laser ablation for benign prostatic hyperplasia: Functional outcomes and predictors of clinical improvement.}},
author = {Juan Varela and Rafael Aldaya Bourricaudy and Evren Cekin and Brian Miles and Victoria Yvonne Bird},
journal = {Central European journal of urology},
year = {2026},
month = may,
doi = {10.5173/ceju.2025.0090},
url = {https://europepmc.org/article/MED/42904076},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Office-based transperineal laser ablation for benign prostatic hyperplasia: Functional outcomes and predictors of clinical improvement.
AU - Juan Varela
AU - Rafael Aldaya Bourricaudy
AU - Evren Cekin
AU - Brian Miles
AU - Victoria Yvonne Bird
PY - 2026
DA - 2026/05/11
JO - Central European journal of urology
DO - 10.5173/ceju.2025.0090
UR - https://europepmc.org/article/MED/42904076
AB - Introduction Transperineal laser ablation (TPLA) is an ultrasound-guided, office-based procedure for the treatment of benign prostatic hyperplasia (BPH). This study evaluates short-term functional outcomes following TPLA and identifies predictors of clinical improvement.Material and methods This cohort included men undergoing TPLA between January 1, 2025, and February 1, 2026, using a transperineal interstitial laser system (EchoLaser, Elesta SpA). Minimum follow-up was 6 months. Variables included age, body mass index (BMI), prostate-specific antigen (PSA), PSA density, testosterone, prostate volume, International Prostate Symptom Score (IPSS), peak urinary flow rate (Qmax), and post-void residual (PVR). Intraoperative variables included ablation time and energy delivered. Pre- and post- treatement differences were assessed using the Wilcoxon signed rank test. Spearman correlation analysis evaluated predictors of improvement.Results Thirty-five of forty men met the inclusion criteria. Mean prostate volume was 71.6 cm³ (range 29.8-196). Mean IPSS improved from 23.5 to 10.6 (p <0.001). Qmax increased from 7.2 to 18.4 ml/s (p = 0.007). PVR decreased from 396.8 to 70.6 ml (p <0.001). Comorbidities included urinary tract infection or urosepsis history, hypertension, diabetes, hypercholesterolemia, and anticoagulation use. Postoperative complications included three patients with urinary retention requiring catheterization and one patient with urosepsis requiring hospitalization. Greater improvement correlated with higher baseline IPSS and PVR (p <0.001).Conclusions Office-based TPLA produced significant short term functional improvement. Functional gains were comparable to those achieved with hospital based surgical interventions. Prospective, multicenter, randomized studies are warranted to further evaluate long term durability.
SN - 2080-4806
SN - 2080-4873
ER -