Transperineal laser ablation for treating lower urinary tract symptoms of benign prostatic hyperplasia

NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 11 sources, which was discussed by the committee. The evidence included 2 randomised controlled trials, 2 systematic reviews (1 of which also included 1 of the randomised controlled trials), and 7 prospective case series. It is presented in the summary of key evidence section in the interventional procedures overview.

The professional experts and the committee considered the key efficacy outcomes to be: reduction in lower urinary tract symptoms, and preservation of sexual function, including ejaculatory function.

The professional experts and the committee considered the key safety outcomes to be: damage to adjacent structures, need for reintervention, urinary incontinence and urinary retention.

Patient commentary was sought but none was received.

The upper size limit for a prostate to be treated using this procedure is unknown. There are uncertainties about its use in median lobes and it may be contraindicated in people with heavily calcified prostates.

People who have the procedure in the UK may need temporary catheterisation afterwards. There have been reports of some people who do not need catheterisation.