RESUMEN
PURPOSE: To evaluate the durability, effectiveness, and safety of transperineal laser ablation (TPLA) of the prostate. MATERIALS AND METHODS: Patients with symptomatic benign prostatic hyperplasia (BPH) underwent TPLA with a 1,064-nm continuous-wave diode laser. International Prostate Symptom Score (IPSS), quality of life (QoL), postvoid residual (PVR), and prostate volume were evaluated at baseline and successive timepoints. RESULTS: Forty prospectively enrolled patients had follow-up of ≥36 months; median duration of follow-up was 57 months (range, 36-76 months). Compared with baseline, the median reduction in IPSS at 12-month follow-up was 74% (interquartile range [IQR], 60%-81%) (P < .001). Median QoL score at 12 months was improved from 5 (IQR, 4-5) at baseline to 1 (IQR, 0-1) (P < .001). Median PVR at 12 months decreased from 108 mL (IQR, 38-178 mL) to 13.5 mL (IQR, 0-40.5 mL) (P < .001), a median reduction of 88% (IQR, 61%-100%). At 12 months, median prostate volume was significantly reduced from 66 mL (IQR, 48.5-86.5 mL) to 46 mL (IQR, 36-65 mL) (P < .001), a median reduction of 32% (IQR, 21%-45%). For all of these parameters, the benefit of TPLA persisted at last follow-up, and all changes were statistically significant compared with baseline. There were no intraprocedural adverse events; periprocedural adverse events consisted of 1 case of prostatitis and 1 case of urinary tract infection (both Society of Interventional Radiology [SIR] Grade I). CONCLUSIONS: TPLA for symptomatic BPH produced durable benefits across a range of clinical outcomes and was well tolerated in follow-up at median duration of 57 months.
Asunto(s)
Terapia por Láser , Hiperplasia Prostática , Calidad de Vida , Humanos , Masculino , Hiperplasia Prostática/cirugía , Hiperplasia Prostática/diagnóstico por imagen , Hiperplasia Prostática/fisiopatología , Anciano , Resultado del Tratamiento , Terapia por Láser/efectos adversos , Persona de Mediana Edad , Estudios Prospectivos , Factores de Tiempo , Láseres de Semiconductores/uso terapéutico , Láseres de Semiconductores/efectos adversos , Estudios de Seguimiento , Síntomas del Sistema Urinario Inferior/etiología , Síntomas del Sistema Urinario Inferior/fisiopatología , Síntomas del Sistema Urinario Inferior/cirugía , Síntomas del Sistema Urinario Inferior/diagnóstico por imagen , Perineo/cirugía , Anciano de 80 o más AñosRESUMEN
To the Editor, Erectile dysfunction (ED) is one of the most prevalent conditions affecting men globally, with significant psychological and social consequences. The prevalence varies across different populations, and it is estimated around 50% in men aged between 40 to 70. The etiology of ED is multifactorial, involving a complex crosstalk between psychological, hormonal, neurogenic, vascular, and structural factors [...].