Transurethral Dehydrated Ethanol Injection of the Prostate for the Treatment of Benign Prostatic Hyperplasia (bph): a Preliminary Report

Purpose To evaluate the efficacy and safety of a minimally invasive treatment for benign prostatic hyperplasia (BPH) by transurethral dehydrated ethanol injection. Patients and method Eight patients with clinical symptoms of benign prostatic hyperplasia were evaluated by urodynamic study, cystoscope and transrectal ultrasound preoperatively. Under regional anesthesia, transurethral injection was performed at 6-10 sites into median and bilateral prostatic lobes, and 12-20 mL of dehydrated ethanol was used depending on the prostatic size in each patient. At 3 months after treatment, International prostatic symptom score (IPSS), quality of life score and parameter of benign prostatic obstruction (BPO) were re-evaluated and compared with the baseline. Result Average operative time was 19.29 minutes (range 15-30). There were no intra operative complications, but the postoperative treatment required catheterization for a mean of 11 days (range 7 to 39). Gross hematuria and blood clot obstruction had caused irrigate bladder to occur in 1 patient. Only 1 patient could not remove the urethral catheter in 4 weeks, so he was offered transurethral resection of the prostate. Seven patients completed the study. The median IPSS was 23 (range 16 to 31) preoperatively, and it significantly improved to 5 (range 2 to 17) at 3 months postoperatively (p=0.018). The median quality of life score also improved significantly from 5 (range 4 to 6) to 1 (range 0 to 2) (p=0.016). The mean residual urine volume significantly decreased from 103.71±70.88 to 21.29±18.36 mL (p=0.016). However, the mean peak urinary flow rate increased, but not significantly, and there was no significant change in mean prostate volume from 39.30±28.11 to 28.44±12.90 mL (p=0.241). Conclusion Our preliminary data proved that this technique is an effective alternative treatment with minimal adverse effects, and it is safe for patients with benign prostatic hyperplasia, especially when there is a high operative risk. Chiang Mai Med J 2007;46:(2):67-74.