MP27-11 12-MONTH CLINICAL OUTCOMES OF MRI-GUIDED TRANSURETHRAL ULTRASOUND ABLATION (TULSA) IN MEN WITH BENIGN PROSTATIC HYPERPLASIA (BPH)

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology II (MP27)1 May 2024MP27-11 12-MONTH CLINICAL OUTCOMES OF MRI-GUIDED TRANSURETHRAL ULTRASOUND ABLATION (TULSA) IN MEN WITH BENIGN PROSTATIC HYPERPLASIA (BPH) Mikael Anttinen, Antti Viitala, Pouya Doerwald, Pietari Mäkelä, Pertti Nurminen, Heikki Pärssinen, Teija Sainio, Pekka Taimen, Roberto Blanco Sequeiros, and Peter J. Boström Mikael AnttinenMikael Anttinen , Antti ViitalaAntti Viitala , Pouya DoerwaldPouya Doerwald , Pietari MäkeläPietari Mäkelä , Pertti NurminenPertti Nurminen , Heikki PärssinenHeikki Pärssinen , Teija SainioTeija Sainio , Pekka TaimenPekka Taimen , Roberto Blanco SequeirosRoberto Blanco Sequeiros , and Peter J. BoströmPeter J. Boström View All Author Informationhttps://doi.org/10.1097/01.JU.0001009400.86696.a2.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: MRI-guided transurethral ultrasound ablation (TULSA) offers an effective therapy option for treating benign prostatic hyperplasia (BPH). This report presents the 12-month clinical outcomes for 30 men treated in a phase 1-2 study. METHODS: Men with LUTS due to BPH, previously scheduled for primary TURP, were enrolled in this prospective, investigator-initiated, single-center, phase 1-2 study (NCT03350529). Quality of life (QoL) questionnaires including EPIC-26, IPSS , IIEF-5 as well as uroflowmetry and PSA were recorded at baseline, 3, 6, 9, 12, 18, 24, and 36 months post-TULSA. MRI was obtained at baseline, 3- and 12-months. Medication use before and after TULSA and adverse events (AEs) recorded in Clavien-Dindo. RESULTS: 30 patients received TULSA, with a median follow-up of 16-mo (max 48-mo). At baseline, median [IQR] age was 67 years [64–72], PSA 3.1 ug/l [2.2–6.9], prostate volume 51.5 ml [min 29-max 107], average flow rate 4.1 ml/s [3.4–7], maximum flow rate 11 ml/s [8–15], voided volume 211 ml [139–336], and post-void residual 71 ml [40–247]. Median sonication, hospitalization, and catheterization times were 39 min, 24 h, and 16 d, respectively. AEs included one grade 1, 8 grade 2, and one grade 3 events, including urinary tract infection, urinary retention, and epididymitis (grade 3), all resolving within three months. 25/30 patients have completed their 12-mo follow-up with 2 men dropping off due to cancer diagnosis. Between baseline and 12 months, median values for measured parameters changed as follows: prostate volume (based on the elliptic formula) reduced from 51.5 to 31 ml, PSA reduced from 3.1 to 1.5 ug/l, post-void residual volume decreased from 71 to 41 ml, average flow rate increased from 4.1 to 8.9 ml/s, Qmax increased from 11 to 17 ml/s, voided volume increased from 211 to 290 ml, IPSS score improved from 16.5 to 4, IPSS QoL score improved from 4 to 1, IIEF-5 improved from 15 to 18, EPIC-26 urinary incontinence domain improved from 85.5 to 100, EPIC-26 irritative/obstructive domain improved from 65.6 to 94, EPIC-26 bowel domain improved from 87.5 to 100, EPIC-26 sexual domain improved from 54 to 67, and EPIC-26 hormonal domain improved from 95 to 100. Uroflowmetry, functional status, and QOL questionnaires all improved at 12 months despite discontinuation of LUTS medication in 26/30 patients, who received medication before TULSA. CONCLUSIONS: TULSA is a safe and effective therapy option for the treatment of BPH. Short to mid-term outcomes of this phase 1-2 study demonstrated durable symptom relief and quality-of-life improvements. Source of Funding: Profound Medical © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e427 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Mikael Anttinen More articles by this author Antti Viitala More articles by this author Pouya Doerwald More articles by this author Pietari Mäkelä More articles by this author Pertti Nurminen More articles by this author Heikki Pärssinen More articles by this author Teija Sainio More articles by this author Pekka Taimen More articles by this author Roberto Blanco Sequeiros More articles by this author Peter J. Boström More articles by this author Expand All Advertisement PDF downloadLoading ...