Bipolar Radiofrequency Ablation Treatment for Benign Prostatic Hyperplasia: A Retrospective Study of Efficacy and Safety in High-Risk Patients.

Background: Benign prostatic hyperplasia (BPH) is a common condition, particularly among high-risk patients who are unsuitable for surgical intervention due to comorbidities or anticoagulant use. Bipolar radiofrequency ablation is a minimally invasive technique that has been studied for its potential safety and efficacy. This study aimed to investigate the effectiveness of bipolar radiofrequency ablation in treating BPH and to identify the factors influencing the procedural success in high-risk patients.

Methods: Forty-six patients who underwent radiofrequency ablation treatment for prostate between 2018 and 2022 were included in this study. Pre-procedure prostate volume, International Prostate Symptom Score (IPSS), post-voiding residual urine volume (PVR), maximum urine flow rate (Qmax) on uroflowmetric examination, quality of life (QoL) due to urinary symptoms, metabolic syndrome status and bladder wall thickness on ultrasonographic examination were measured and compared with the values at the 3rd month of follow-up.

Results: The mean age of the patients was 75.34 ± 10.67 years (55-94 years). Qmax, PVR, QoL and IPSS improved in all the patients after the procedure (p < 0.001). High pre-procedure PVR, low pre-procedure Qmax and prostate volume less than 70 g were found to be statistically significant factors affecting the success of the procedure (p = 0.03, 0.03, 0.04) (odds ratio (OR) = 1.15, 0.75, 1.30).

Conclusions: Bipolar radiofrequency ablation for prostate is a safe option with a low incidence of side effects and complications for patients who are at high anaesthetic risk due to comorbidities or anticoagulant/antiplatelet therapy and unsuitable or hesitant to undergo for surgery because of potential surgical complications and side effects.