Transurethral Ethanol Ablation of the Prostate for Symptomatic Benign Prostatic Hyperplasia: Long-Term Follow-Up

Abstract

Over the past decade, a variety of new minimally invasive therapies (MIT) have been developed for the treatment of patients with bladder outflow obstruction from benign prostatic hyperplasia (BPH). Transurethral ethanol ablation of the prostate (TEAP) has been introduced as a minimally invasive alternative treatment for patients with BPH. In this study, we present our experience and results of long-term follow-up of 54 months after treatment of symptomatic BPH with TEAP. Fifty-six men with symptomatic BPH were enrolled in our study; all patients were medically high-risk patients with multiple comorbidities. Procedures were performed under intravenous sedation combined with local urethral instillation of lidocaine jelly and a transrectal ultrasonography (TRUS)-guided periprostatic block. Dehydrated ethanol in a concentration of 95% to 98% was injected transurethrally by means of the Postaject Ethanol Injection System using a rigid cystoscope. The following data were collected: International Prostate Symptom Score, prostate-specific antigen level, prostate volume using TRUS, maximum urine flow rate, and postvoid residual. There was sufficient response in 73% of our patients, while the remaining 23% showed an insufficient response and needed alternative treatment. TEAP is an effective minimally invasive treatment option for medically high-risk symptomatic patients with BPH that can be performed as an outpatient procedure under regional anesthesia. The procedure is easy, available, inexpensive, safe, and rapid. Further larger-scale, long-term multi-institutional trials are needed.