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Benign Prostatic Hyperplasia and Prostate Cancer Laser Ablation

  • Claudio Maurizio Pacella
  • Giovanni Mauri
  • Guglielmo Manenti
  • Tommaso Perretta
  • Gianluigi Patelli
Chapter

Abstract

Treatment of symptoms of the lower urinary tract due to benign prostatic obstruction (LUTS/BPH) in men with transperineal laser ablation (TPLA) may offer advantages in terms of functional outcome and safety compared to current standard therapies. Because the technique is relatively new, the indications and outcomes for this treatment are being investigated. However, it is already applied outside of clinical trials. The results of the feasibility study are excellent in terms of both clinical and safety improvements. No significant procedural, periprocedural, and distant complications have been reported so far. In particular, severe complications such as incontinence, erectile dysfunction, retrograde ejaculation, and urethral stenosis have not yet been reported. It is necessary to acquire clinical information from these treatments to plan future research.

Prostate cancer (PCa) is the second cause of cancer-related deaths for men. The standard surgical treatment is radical prostatectomy. Possible side effects of this treatment are incontinence and erectile dysfunction. These side effects are especially undesired in patients with only a small focus of PCa. A focal treatment without these side effects is desirable and must be researched. Focal laser ablation (FLA) is an investigated technique for local treatment. So far the single fiber setup of most systems requires fiber replacement. This leads to longer treatment duration and thus higher costs. The EchoLaser system is a laser ablation system with four laser sources. This provides a larger treatment area, without the need for fiber replacement. This makes the system ideal for FLA of prostate cancer, especially since it can be applied under local anesthesia.

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Claudio Maurizio Pacella
    • 1
  • Giovanni Mauri
    • 2
  • Guglielmo Manenti
    • 3
  • Tommaso Perretta
    • 3
  • Gianluigi Patelli
    • 4
  1. 1.Department of Diagnostic Imaging and Interventional RadiologyRegina Apostolorum HospitalAlbano LazialeItaly
  2. 2.Division of Interventional RadiologyEuropean Institute of Oncology, IRCCSMilanItaly
  3. 3.Department of Diagnostic Imaging and Interventional RadiologyTor Vergata UniversityRomeItaly
  4. 4.Department of Diagnostic and Interventional RadiologyPesenti-Fenaroli Hospital-ASST BergamoestAlzano LombardoItaly

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