Magnetic resonance imaging‐guided transurethral ultrasound ablation for benign prostatic hyperplasia: 12‐month clinical outcomes of a phase I study

We aimed to investigate the safety and feasibility of MRI‐guided transurethral ultrasound ablation (TULSA) for the treatment of benign prostatic obstruction (BPO). Men with lower urinary tract symptoms due to BPH in need of surgical intervention were enrolled in the study and followed for 12 months after TULSA. MRI was done at baseline, and at 3 and 12 months after TULSA. At baseline, 6 patients were moderately symptomatic and 4 were severely symptomatic. 9 patients at baseline were on BPO medication. The median (IQR) improvement in the IPSS was 82%, from 17.5 at baseline to 4.0 at 12 months. The maximum urinary flow rate improved by 101% at 12 months starting at 3 months. The median prostate volume and PSA reduction at 12 months were 33% and 48%, respectively. No changes in continence, sexual, erectile or bowel functions. All patients taking BPO medication before TULSA discontinued medication after TULSA. Thus, TULSA appears to be a safe and effective treatment for BPO, with promising 12‐month follow‐up outcomes.