Transperineal laser ablation of the prostate as a treatment for benign prostatic hyperplasia and prostate cancer: The results of a Delphi consensus project
Year: 2023
Type: article
Abstract: Objective: To evaluate transperineal laser ablation (TPLA) with Echolaser® (Echolaser® TPLA, Elesta S.p.A., Calenzano, Italy) as a treatment for benign prostatic hyperplasia (BPH) and prostate cancer (PCa) using the Delphi consensus method. Methods: Italian and international experts on BPH and PCa participated in a collaborative consensus project. During two rounds, they expressed their opinions on Echolaser® TPLA for the treatment of BPH and PCa answering online questionnaires on indications, methodology, and potential complications of this technology. Level of agreement or disagreement to reach consensus was set at 75%. If the consensus was not achieved, questions were modified after each round. A final round was performed during an online meeting, in which results were discussed and finalized. Results: Thirty-two out of forty invited experts participated and consensus was reached on all topics. Agreement was achieved on recommending Echolaser® TPLA as a treatment of BPH in patients with ample range of prostate volume, from <40 mL (80%) to >80 mL (80%), comorbidities (100%), antiplatelet or anticoagulant treatment (96%), indwelling catheter (77%), and strong will of preserving ejaculatory function (100%). Majority of respondents agreed that Echolaser® TPLA is a potential option for the treatment of localized PCa (78%) and recommended it for low-risk PCa (90%). During the final round, experts concluded that it can be used for intermediate-risk PCa and it should be proposed as an effective alternative to radical prostatectomy for patients with strong will of avoiding urinary incontinence and sexual dysfunction. Almost all participants agreed that the transperineal approach of this organ-sparing technique is safer than transrectal and transurethral approaches typical of other techniques (97% of agreement among experts). Pre-procedural assessment, technical aspects, post-procedural catheterization, pharmacological therapy, and expected outcomes were discussed, leading to statements and recommendations. Conclusion: Echolaser® TPLA is a safe and effective procedure that treats BPH and localized PCa with satisfactory functional and sexual outcomes.
Source: Asian journal of urology
Authors: Andrea Cocci, Marta Pezzoli, Fernando Bianco, Franco Blefari, Pierluigi Bove, Francois Cornud, Gaetano De Rienzo, Paolo Destefanis, Danilo Di Trapani, Alessandro Giacobbe, Luca Giovanessi, Antonino Laganà, Giovanni Lughezzani, Guglielmo Manenti, Gianluca Muto, Gianluigi Patelli, Novello Pinzi, Stefano Regusci, Giorgio I. Russo, Juan I.M. Salamanca, Matteo Salvi, Luigi Silvestri, Fabrizio Verweij, Eric Walser, Riccardo G. Bertolo, Valerio Iacovelli, Alessandro Bertaccini, Debora Marchiori, Hugo Davila, Pasquale Ditonno, Paolo Gontero, Gennaro Iapicca, Theo M De Reijke, Vito Ricapito, Pierluca Pellegrini, Andrea Minervini, Sergio Serni, Francesco Sessa
Institutions: Azienda Ospedaliero-Universitaria Careggi, University of Florence, Hospital of Prato, University of Rome Tor Vergata, Hôpital Cochin, Assistance Publique – Hôpitaux de Paris, Université Paris Descartes, University of Bari Aldo Moro, Azienda Ospedaliera Citta' della Salute e della Scienza di Torino, University of Turin, Ospedale Buccheri la Ferla Fatebenefratelli, Ospedale Humanitas Gradenigo, Fondazione Poliambulanza Istituto Ospedaliero, Humanitas University, IRCCS Humanitas Research Hospital, Ospedale Pesenti Fenaroli, Azienda Socio Sanitaria Territoriale Bergamo Est, University of Siena, Générale-Beaulieu Clinic, European Organization for Nuclear Research, University of Catania, Universidad Francisco de Vitoria, Hospital Universitario Puerta de Hierro Majadahonda, Sapienza University of Rome, European Institute of Oncology, The University of Texas Medical Branch at Galveston, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola, Florida Cancer Specialists & Research Institute, Amsterdam University Medical Centers, University of Amsterdam, Azienda Universitaria Ospedaliera Consorziale - Policlinico Bari
Language: English
Subfield: Urology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4383888043