Tissue Ablation in Benign Prostatic Hyperplasia with High-Intensity Focused Ultrasound

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Abstract
The safety and effectiveness of tissue ablation by coagulative necrosis with high-intensity focused ultrasound (HIFU) applied through a rectal probe to 36 patients with symptomatic benign prostatic hyperplasia (BPH) was investigated in a phase II clinical trial. Overall, HIFU treatment was well tolerated, the mean hospital stay being 1.1 days. Negative side effects were transient urinary retention in 32/36 patients, hematuria in 2 patients and hematospermia resolving after 3-4 weeks (n = 15). After 3 months the maximum flow rate/s (Qmax) increased from 9.0 ± 3.9 to 14.4 ± 7.0 ml/s, the median flow rate/s (QM90) from 4.9 ± 2.4 to 7.6 ± 4.17 ml/s; the postvoid residual volume decreased from 128 ± 88 to 57 ± 35 ml and the AUA symptom score from 25.5 ± 5 to 13.2 ± 4.4. In conclusion, it was shown that tissue ablation in patients with symptomatic BPH using HIFU is safe and dramatically reduces both obstructive and irritative symptoms and leads to a significant increase in uroflow and a decrease in postvoid residual volume.

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