To investigate the safety, feasibility and clinical value of the ultrasound-guided transperineal laser ablation (TPLA) for benign prostatic hyperplasia (BPH) and to explore a new method for BPH treatment.

Two patients with severe benign prostatic hyperplasia, who had experienced drug treatment failure and had intolerance to conventional surgery, were treated by TPLA. The postoperative range of ablation was evaluated by contrast-enhanced ultrasound and complications were observed. The patients were closely followed up in one and two months after operation. The curative effect was evaluated and the imaging examination was performed.

The immediate contrast-enhanced ultrasound of the two patients confirmed that the ablation area of both left and right inner gland were in accordance with the preoperative surgical plan and no obvious complications were observed. The follow-ups after the operation suggested that the lower urinary tract symptoms of the two patients were significantly improved. The International Prostate Symptom Score (IPSS) decreased from 35 points and 32 points to 5 points and 6 points, respectively. The preoperative prostatic volumes were 62.7 ml and 84.3 ml, while the postoperative volumes were 61.2 ml and 84.1 ml, respectively.

TPLA is a safe, accurate and minimally invasive method with significant short-term curative effect, which can provide a new idea for the treatment of BPH with clinical drug treatment failure and non-tolerance to conventional surgery.