Interventional procedure overview of image-guided transperineal laser ablation (TPLA) for treating lower urinary tract symptoms caused by benign prostatic hyperplasia

Indications and current treatment

BPH, also known as BPO or BPE, is a common condition that affects older people with a prostate. Stromal and epithelial cells increase in number, causing the prostate to get bigger. It often happens in the periurethral region of the prostate, with large discrete nodules compressing the urethra. Symptoms include hesitancy during urination, interrupted or decreased urine stream (volume and flow rate), nocturia, incomplete voiding and urinary retention.

Mild symptoms are usually managed conservatively. Drugs may also be offered, such as alpha-adrenoceptor blockers and 5‑alpha-reductase inhibitors. If other treatments have not worked, surgical options include TURP, transurethral vaporisation, holmium laser enucleation, insertion of prostatic urethral lift implants, prostatic artery embolisation or prostatectomy (see NICE's guideline on lower urinary tract symptoms in men). Potential complications of some of these surgical procedures include bleeding, infection, urethral strictures, incontinence and sexual dysfunction.