A PROSPECTIVE, RANDOMIZED 1-YEAR CLINICAL-TRIAL COMPARING TRANSURETHRAL NEEDLE ABLATION TO TRANSURETHRAL RESECTION OF THE PROSTATE FOR THE TREATMENT OF SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA

Purpose: We assess the 1-year efficacy and safety of transurethral nee dle ablation of the prostate compared to transurethral resection of th e prostate for the treatment of symptomatic benign prostatic hyperplas ia (BPH). Materials and Methods: A prospective, randomized clinical tr ial of 121 men 50 years old or older with symptomatic BPH was performe d at 7 medical centers across the United States. Of the men 65 (54%) w ere treated with transurethral needle ablation of the prostate and 56 (46%) underwent transurethral resection of the prostate. Mean and perc entage changes from baseline and between cohorts for American Urologic al Association (AUA) symptom score, AUA bother score, quality of life score, peak urinary flow rate and post-void residual urine volume were measured at 1, 3, 6 and 12 months following treatment. Length of proc edure, hospitalization, type of anesthesia, post-procedure catheteriza tion, side effects and sexual function were compared. Results: Transur ethral needle ablation and resection resulted in a statistically signi ficant improvement in AUA symptom, bother and quality of life scores, peak urinary flow rate and post-void residual. At 1-year followup, nee dle ablation and resection were equally effective in enhancing quality of life. Needle ablation had less effect on sexual function, with res ection being associated with a greater incidence of retrograde ejacula tion. Needle ablation could be performed as an outpatient procedure wi th local anesthesia while resection required anesthesia and hospitaliz ation. Needle ablation was associated with markedly fewer side effects than resection. Conclusions: Compared to transurethral resection of t he prostate, transurethral needle ablation of the prostate is an effic acious, minimally invasive treatment for symptomatic BPH that is assoc iated with few side effects.