LASER PROSTATECTOMY - INITIAL EXPERIENCE AND URODYNAMIC FOLLOW-UP

Objectives. An evolving technology for the treatment of bladder outlet obstruction due to benign prostatic hyperplasia (BPH) is the use of t he side-firing neodymium: yttrium-aluminum-garnet (Nd:YAG) laser to ac hieve prostatic tissue ablation. The purpose of this study was to dete rmine the short-term efficacy of this procedure in both an objective a nd subjective manner. Methods. We examined this technique by carefully evaluating our first 25 men undergoing the procedure. Each patient wa s subjected to careful symptom score analysis using the American Urolo gical Association symptom index and multichannel urodynamics, includin g pressure-flow studies both preoperatively and at 3 months postoperat ively. Results. At the 3-month follow-up, symptom scores improved from a preoperative mean of 11.4 to 7.2 and the mean maximum flow rate imp roved from 6.1 to 14.5 cc/s. These are both significant at P <0.001. S tatistically similar improvement was seen in detrusor pressure at open ing and at maximum flow. Eighty percent of the men studied had at leas t a 50% reduction in symptom score and a 50% improvement in flow rate. Conclusions. We conclude that laser prostatectomy is a promising mini mally invasive treatment for bladder outlet obstruction secondary to B PH and deserves further evaluation at longer terms of follow-up.