Ethanol injection therapy of the prostate for benign prostatic hyperplasia: Preliminary report on application of a new technique

Purpose: We evaluate the efficacy of a new technique of minimally invasive treatment for benign prostatic hyperplasia involving direct injection of dehydrated ethanol. Materials and Methods: Dehydrated ethanol was injected transurethrally with lumbar or sacral and urethral anesthesia in 10 patients with prostatic hyperplasia. Endoscopic injection was performed at 4 to 8 sites in the prostate and 3.5 to 12.0 ml. ethanol were used. Results: There were no intraoperative complications but postoperative urinary retention occurred transiently in all patients which required catheterization for a mean of 8.8 days. Mean symptom score plus or minus standard deviation was 12.2 +/- 5.8 at 3 months postoperatively, which was significantly improved from 23.1 +/- 7.0 preoperatively (p < 0.01). Mean quality of life score also improved significantly from 5.1 +/- 0.6 preoperatively to 3.2 +/- 1.5 at 3 months postoperatively (p < 0.01), mean peak urinary flow rate increased from 8.0 +/- 2.2 (9 patients) to 13.1 +/- 3.6 ml. per second (p < 0.05) and mean residual urine volume decreased from 129.1 +/- 55.3 (9 patients) to 49.3 +/- 34.7 ml. (p < 0.05). There was no significant change in prostate volume. Acute epididymitis and chronic prostatitis occurred in 1 patient each. Conclusions: This technique can be performed as an outpatient procedure and appears to be safe and cost-effective. Retrograde ejaculation can be avoided.