Transperineal laser ablation A novel minimally invasive treatment for lower urinary tract symptoms in men

Benign prostatic enlargement (BPE) is common in elderly men, caused by the continuous growth of the prostate. As the prostate enlarges, it puts pressure on the urethra, leading to benign prostatic obstruction (BPO) and lower urinary tract symptoms (LUTS). These symptoms include a weak urine stream, frequent urination, urgency, nocturia (nighttime urination), and incomplete bladder emptying. The prevalence of LUTS increases with age, affecting 9-20% of men aged 50 to 78, and over 30% of men older than 85. LUTS negatively impacts quality of life (QoL), as it disrupts daily functioning, vitality, and sleep, particularly with nocturia.
Transurethral resection of the prostate (TURP) is a common surgical treatment for LUTS caused by BPO. While effective, TURP carries risks of complications like bleeding and infection, and often leads to retrograde ejaculation. In response, minimally invasive treatments (MITs) have been developed to reduce risks, although they generally result in less improvement in urination compared to TURP, and comparisons between MITs are lacking.
Transperineal laser ablation (TPLA) is a new MIT for treating LUTS caused by BPO. TPLA uses multiple laser sources, potentially shortening treatment time and increasing effectiveness. Initial studies suggest that TPLA significantly improves urination and symptoms, particularly in men unable to undergo surgery, though its effectiveness in men eligible for surgery remains unclear.
This thesis aims to evaluate various MITs for LUTS, specifically assessing the effectiveness, predictability, and tissue changes resulting from TPLA, and explores creating a predictive model through laboratory experiments.