Transperineal Laser Ablation for Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis
Abstract
Benign prostatic hyperplasia (BPH) is a common cause of lower urinary tract symptoms, affecting quality of life (QoL) in ageing men. While transurethral resection of the prostate (TURP) remains the standard treatment, its complications have spurred interest in less invasive alternatives. Transperineal laser ablation (TPLA) has emerged as a promising option. This systematic review and meta-analysis evaluate the safety and efficacy of TPLA for BPH.
A systematic search of PubMed, Scopus, Cochrane CENTRAL, Web of Science, and Ovid was conducted in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included studies were either prospective or retrospective, involving adult males with BPH treated through TPLA. Outcomes assessed included Qmax, postvoid residual (PVR), prostate volume, International Prostate Symptom Score (IPSS), sexual function, and QoL. The meta-analysis was performed using MedCalc software, with heterogeneity and sensitivity analyses.
Nineteen studies (sample sizes 20–160), primarily from Italy. All used transperineal diode laser ablation, most of them done under local anesthesia. TPLA significantly improved urinary outcomes: At 6–12 months, there was a significant reduction in the IPSS with a mean difference of −12.78. Qmax increased by a mean of −5.33 mL/s. PVR decreased by 59.8 mL. QoL scores also improved (mean difference: −2.61). While prostate volume was reduced with a mean decrease of 17.4 mL. Sexual function was…
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