ARE CONTACT LASER, INTERSTITIAL LASER, AND TRANSURETHRAL ULTRASOUND-GUIDED LASER-INDUCED PROSTATECTOMY SUPERIOR TO TRANSURETHRAL PROSTATECTOMY

BACKGROUND. In order to assess the value of various new therapeutic mo dalities in the management of benign prostatic hyperplasia (BPH), we p erformed a prospective study comparing transurethral resection of the prostate (TURF) to contact Laser, interstitial Laser, and transurethra l ultrasound-guided laser-induced prostatectomy (TULIP). METHODS. The following parameters were evaluated preoperatively as well as 3, 6, an d 12 months after surgery: prostatic volume, urinary now rate, postvoi d residual volume, and the AUA symptom score. The diagnosis of bladder outlet obstruction was established preoperatively by means of pressur e/flow studies which were repeated 1 year after the operation. RESULTS AND CONCLUSIONS. In conclusion, TURP is still the gold standard in th e treatment of BPH. The results of TULIP, contact laser, and interstit ial laser are about the same. The time intervals within which the pati ents become free of symptoms, however, Vary widely. Contact laser is L imited to prostates below 50 cc, while interstitial laser is ideal for patients in poor general health who present with large prostates. Fur thermore, our results demonstrate that the only reliable data for dete rmining the degree of posttherapeutic disobstruction can be provided b y urodynamic investigations including pressure/flow diagrams. (C) 1997 Wiley-Liss, Inc.