Laser prostatectomy - Long-term follow-up of 303 patients

Objective: This retrospective study was undertaken to evaluate results and complications in 303 patients with symptomatic bladder outlet obstruction d ue to benign prostatic hyperplasia (BPH) who underwent laser prostatectomy focusing on the long-term follow-up, 57 patients had a follow-up of more th an 3 years. Materials and Methods: A total of 303 patients were treated wit h the neodymium:YAG laser system for 1993 to 1997, of wh om 57 patients wer e followed up for at least 3 years. All of the patients have been evaluated after 3 months, 6 months and 2 years. 57 patients were evaluated after 3 y ears. Pre- and postoperative American Urological Association (AUA) symptom score, uroflowmetry (UF), and immediate and long-term complications were as sessed. Results: The mean AUA symptom scores of 303 patients decreased over the 24 months follow-up from 16.9 to 7.6. In 57 patients after 36 months t he mean AUA symptom score was 7.1. The mean maximal UF increased over the 2 4 months from 9 to 14.1 cm(3)/s in 303 patients. In 57 patients at 3 years the mean UF was 13.9 cm3/s. The overal complications of 303 patients includ ed two perforations of the bladder wall and two perforations of the prostat ic capsule. Six(1.9%) patients had postoperative febrile UTI and 28 (9.2%) patients had acute urinary retention after catheter removal. Early bleeding occurred in 3 (0.9%) patients, late bleeding in 8 (2.4%), 4 (1.2%) had ure thral stricture, and 1 had stricture of the bladder neck. The overall reope ration rate for symptomatic residual tissue was 1.9% (6 patients). Conclusi on: Neodymium:YAG laser ablation of prostate represents an efficacious surg ical intervention for symptomatic bladder outlet obstruction due to BPH wit h minimal associated morbidity.