CONTACT LASER PROSTATECTOMY

Laser prostatectomy is a recent technique that is evolving rapidly. As new techniques develop, it is important to discriminate between those that merely coagulate the prostate, those that vaporise the prostate and those that do a combination of both. Coagulation of the prostate a lone results in prolonged obstruction and an increased incidence of ur inary tract infection and post-operative dysuria. Vaporisation alone c an result in much more rapid dis-obstruction but the procedure is rela tively slow. For small prostates this is the treatment of choice. It h as not been compared with transurethral incision of the prostate to da te. This trial is indeed indicated. Hybrid procedures are increasing i n popularity because they have the potential to combine the best aspec ts of both coagulation and vaporisation. There is relatively rapid coa gulation of the bulk of the tissue but the vaporised channel allows mo re rapid dis-obstruction, This allows the patient to void more rapidly , thereby reducing the catheter time. The duration of dysuria appears to be reduced. These distinctions in the techniques of laser applicati on and the treatment of prostatic outflow obstruction are important.