Transurethral prostate ablation using saline-liquid electrode introduced via flexible cystoscope

Area of Science:

• Urology
• Minimally Invasive Surgery
• Biomedical Engineering

Background:

• Benign prostatic hyperplasia (BPH) is a common condition requiring effective treatment.
• Current treatments for BPH can involve significant patient discomfort and side effects.
• Radiofrequency (RF) energy delivery to prostate tissue offers a potential therapeutic approach.

Purpose of the Study:

• To evaluate a novel transurethral flexible cystoscope-guided saline-electrode system for creating prostate lesions.
• To assess the safety and efficacy of this minimally invasive RF energy delivery method.
• To determine the relationship between RF energy duration and lesion volume in canine prostates.

Main Methods:

• A 4F catheter with a 26-gauge needle electrode was introduced transurethrally via a flexible cystoscope in 10 dogs.
• Hypertonic saline was infused prior to and during RF energy application (50 W, 475 kHz) for varying durations (30-90 seconds).
• Prostate and urethral temperatures were monitored, with automatic shut-off for excessive temperature or impedance.

Main Results:

• Lesion volumes ranged from 0.99 cm³ to 5.03 cm³, with average volumes increasing with RF application time (1.76 cm³ at 30s to 5.03 cm³ at 90s).
• No automatic shut-offs occurred, indicating a safe temperature and impedance profile within the tested parameters.
• Histological examination confirmed coagulation necrosis without tissue desiccation in the treated areas.

Conclusions:

• Transurethral delivery of RF energy using a saline-electrode via a flexible cystoscope is a feasible and controllable method for creating large prostate lesions.
• This minimally invasive approach demonstrates potential for effective BPH treatment with reduced patient discomfort.
• Further research is warranted to translate these findings to human clinical applications for BPH management.