NEODYMIUM-YAG LASER COAGULATION PROSTATECTOMY - 3 YEARS OF EXPERIENCEWITH 227 PATIENTS

Purpose: For 3 years we prospectively followed a cumulative cohort of men who underwent neodymium:YAG laser coagulation prostatectomy to rel ieve bladder outlet obstruction to determine the safety, efficacy and durability of this procedure. Materials and Methods: A total of 227 me n with symptomatic bladder outlet obstruction was treated with the Uro lase side-firing laser fiber between October 15, 1991 and October 15, 1994. Voiding outcomes, including peak urinary flow rates, residual u rine volumes and American Urological Association symptom scores, were measured with time, and immediate and long-term complications were ass essed. Results: Median patient followup was 26 months (maximum 42). Si gnificant improvement occurred in all measured voiding parameters, inc luding 133% in peak flow rates and 61% in symptom scores 1 year postop eratively. Overall 87% of patients noticed improved quality of life as a result of surgery. Minimum postoperative followup was 6 months in a ll cases, Complications included prostatitis in 2.6% of patients, uret hral structure in 1.8%, bladder neck contracture in 4.4% and reoperati on for residual prostate tissue in 5.3%. Conclusions: Neodymium:YAG la ser coagulation of the prostate represents an efficacious surgical int ervention for symptomatic bladder outlet obstruction with minimal asso ciated morbidity. Voiding outcomes are durable through 3 years.