Concomitant Trans-Perineal Prostate Biopsy and Ablation (Bioblation) for Prostate Cancer

Validation of Concomitant Trans-Perineal Prostate Biopsy and Ablation (Bioblation) for Symptomatic (LUTS) Selected Most Probably Low and Intermediate Risk PCa Patients

This prospective study aims to validate the clinical outcomes of performing a concomitant trans-perineal prostate biopsy and laser ablation (termed "Bioblation") during a single session. The intervention is designed for symptomatic patients presenting with lower urinary tract symptoms (LUTS) who are highly suspected to have low to favorable intermediate-risk prostate cancer. By combining diagnosis and targeted treatment under local anesthesia, this approach seeks to facilitate early relief of severe symptoms and a rapid return to daily activities. Ultimately, the study evaluates whether this combined procedure decreases the patient's exposure to multiple, temporally separated interventions without compromising oncological safety or efficacy.

Inclusion Criteria:

• Patients with severe Lower Urinary Tract Symptoms (LUTS) meeting the following parameters:

  1. IPSS score > 20
  2. Uroflowmetry flow rate < 10 ml/sec
  3. Post-void residual > 150 cc

• Patients most probably having low to favorable intermediate-risk prostate cancer, defined as:

  1. PSA level between 4 and 20 ng/ml
  2. MP-MRI showing 3 or fewer focal lesions
  3. MP-MRI focal lesions measuring < 1.5 cm

• International or visiting patients requiring early return to their home country due to professional or personal commitments, provided they can undergo short-term management and follow-up coordination

Exclusion Criteria:

• Patient PSA level > 20 ng/ml
• More than 3 focal lesions on MP-MRI
• Metastatic prostate cancer
• History of lower urinary tract surgery (e.g., TURP, Laser, urinary diversions, artificial urinary sphincter)
• History of pelvic radiation therapy or radical pelvic surgery