A prospective randomized controlled trial of hybrid laser treatment or transurethral resection of the prostate, with a 1-year follow-up

Objective To compare the clinical outcome after hybrid laser treatment of t he prostate, combining potassium tilanyl phosphate (KTP) and Nd:YAG lasers, with transurethral resection of the prostate (TURP), Patients and methods A prospective randomized trial was conducted to compare laser treatment and TURP. The hybrid laser treatment technique involved performing initial 30 W KTP vaporizing bladder neck incisions and prostatotomies followed by a 'f ree-paint' application of 60 W Nd:YAG coagulation energy. Patients were re-assessed after 6 weeks, 6 months and 1 year, using the Int ernational Prostate Symptom Score (IPSS) and uroflowmetry. TURF was conduct ed using conventional methods. Results In all, 204 patients were randomized into the study; at 6 weeks the re were significant differences between the groups for the IPSS (12.4 vs 9. 1, P = 0.001) and maximum urinary flow rates (16.1 vs 20.8 mL/S, P < 0,001) in favour of the TURP group. At 6 months and one year this difference had disappeared. Similar numbers of patients in each group complained of bother some postoperative urinary symptoms (23% vs 19%), Blood transfusions (5% vs none) and urethral strictures (9% vs 2%) were more common after TURF, wher eas more early infective complications occurred after hybrid laser treatmen t (24% vs 5%). Only one patient in each group required re-operation because of poor resolution of symptoms, Conclusions At one year, hybrid KTP/Nd:YAG Laser treatment of the prostate M as equivalent to TURF in the improvements in IPSS, maximum urinary now ra te and post-void residual urine.