Transurethral ethanol ablation of the prostate (TEAP): an effective minimally invasive treatment alternative to traditional surgery for symptomatic benign prostatic hyperplasia (BPH) in high-risk comorbidity patients.
OBJECTIVE
To evaluate the efficacy and safety of transurethral ethanol ablation of the prostate (TEAP) for patients with symptomatic benign prostatic hyperplasia (BPH) and high-risk comorbidities.


METHODS
Thirty-six patients (mean age 77.3 years) with symptomatic BPH or persistent urinary retention were assessed at baseline and at 3, 6, and 12 months after treatment. All patients were affected by comorbidities (cardiovascular, respiratory, hematologic, neoplastic, dysmetabolic diseases, or coagulation disorders). Baseline evaluation was achieved by the International Prostate Symptom Score (IPSS) and quality of life (QoL) score, prostate-specific antigen (PSA), prostate transrectal ultrasound (TRUS), and the maximum peak flow rate with evaluation of post-voiding residual urine volume (PVR). Treatment was performed by injecting dehydrated ethanol at a rate correlated to prostate volume into the prostate. The primary end-point for response was > or = 80% improvement of the maximum peak flow rate and significant reduction of the PVR; secondary end-points included symptom improvement (> or = 40% reduction in IPSS and QoL scores). Statistical analysis was carried out with Pearson's Chi-square test and the non-parametric Wilcoxon test with an assigned statistical significance at P < 0.05.


RESULTS
During the active follow-up period, we observed a statistically significant decrease of the baseline at the end of the study in the total IPSS score and in the QoL score. The mean peak flow rate improved from 6.0 +/- 2.40 ml/min to 15.2 +/- 0.14 ml/min (P < 0.001), while the PVR decreased from a baseline value of 290.6 +/- 14.14 ml to 4.2 +/- 14.10 ml (P < 0.001).


CONCLUSIONS
We found that TEAP is a safe minimally invasive treatment, which significantly improves voiding dysfunctions in patients with symptomatic BPH.
Magno
Carlo
C
Department of Urology, University of Messina, Via Consolare Valeria, Messina, 98100, Italy. carlo.magno@unime.it
Mucciardi
Giuseppe
G
Galì
Alessandro
A
Anastasi
Giuseppina
G
Inferrera
Antonino
A
Morgia
Giuseppe
G
D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D015897:Comorbidity; D000431:Ethanol / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011470:Prostatic Hyperplasia / Q000000981:diagnostic imaging / Q000628:therapy*; D011788:Quality of Life; D020728:Transurethral Resection of Prostate; D016896:Treatment Outcome; D014463:Ultrasonography
D000431:Ethanol