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Percutaneous ethanol injection of the prostate as minimally invasive treatment for benign prostatic hyperplasia:
G Savoca1, S De Stefani, I Gattuccio
1Department of Urology, School of Medicine, University of Trieste, Italy.
Objective:
To evaluate the feasibility, safety and efficacy of a minimally invasive treatment for benign prostatic hyperplasia (BPH) consisting of percutaneous ethanol injection inside the prostate under ultrasound surveillance.
Material And Methods:
Transperineal ethanol injection into the prostate was performed in 8 patients who were affected by obstructive BPH according to AUA symptom score, impaired urinary flow, and volume of postvoiding residual urine. Injections were performed under transrectal ultrasound surveillance at four sites of the prostate for an overall amount of 6 ml of ethanol per patient. The procedure was performed under local anesthesia.
Results:
The patients' median age was 69.7 years (range 57-83). No major intraoperative or postoperative complications were encountered. The median symptom score decreased from 21+/-5.2 (range 14-28) to 10+/-4.4 (range 1-14) at 3 months postoperatively (p<0.0001). The median peak flow rate increased significantly from 11 ml/s (range 7-17) before the procedure to 16 ml/s (range 12-20) after it (p<0.001). The median volume of post-voiding residual urine dropped from 130 ml (range 36-200) before treatment to 27 ml (range 11-42) after it (p<0.01). The same parameters were assessed at 6 months without significant differences. A mild side effect was observed in 1 patient who reported severe urge incontinence and moderate perineal pain the first month after the procedure.
Conclusion:
Percutaneous ethanol injection therapy of the prostate is a safe, easy and minimally invasive procedure for treating BPH, especially when there is an high operative risk.
