COMBINATION HOLMIUM AND ND-YAG LASER-ABLATION OF THE PROSTATE - INITIAL CLINICAL-EXPERIENCE

The holmium laser is a recent addition to the urologist's armamentariu m, being used primarily for the destruction of urinary calculi. Its us e as a tool for ablation of the prostate has not been previously descr ibed. Our initial experience with 110 patients who have undergone a co mbination procedure using the Nd:YAG laser for standard circumferentia l coagulation followed by holmium laser ablation is reported. A furthe r 32 patients who have had a holmium-only technique are described. In the patients who had the combination technique, the AUA Symptom Score improved from a mean value of 19.8 preoperatively to 7.8 at 3 months. The peak urine flow rate likewise improved, from a mean of 8.9 mL/sec preoperatively to 15.1 mL/sec at 3 months. Only one patient who had th e holmium-only technique required recatheterization, compared with nin e patients who had the combination procedure. The combination Ho/Nd:YA G laser ablation technique is evolving, The early results of the holmi um-only technique suggest an advantage over the combination with regar d to catheterization time and degree of irritative symptoms. The longe r-term results must be assessed to confirm this impression.