The value of urodynamics in laser prostatectomy

Objective: To present the results of laser prostatectomy on urodynamic para meters, and to address the role of pressure/flow studies as diagnostic tool s for optimal selection of candidates for this treatment modality. Material and Methods: The world literature, available on Medline, presentin g urodynamic parameters in patients subjected to laser prostatectomy was st udied. We compared the data of different series, and when it was feasible f rom intrinsic features of a particular study, urodynamic results were plott ed on the ICS Provisional Nomogram. Results: A general shift to a less obstructive status has been documented i n all series, using different methods of data interpretation. No clear diff erences, in terms of elimination of obstruction, could be detected among di fferent types of laser. Plotting the data on the ICS Provisional Nomogram, most series slide from the obstructed to the unobstructed zone. The observa tion that clearly obstructed groups accomplish the most impressive results, further emphasizes the value of urodynamics in the initial evaluation of b enign prostatic hyperplasia patients by assisting in the appropriate choice of the therapeutic modality. Conclusions: Using the objective parameters of infravesical obstruction, la ser prostatectomy has proved an effective treatment of benign prostatic hyp erplasia. The role of pressure/flow studies in patient selection is justifi ed, as this investigation permits identification of those cases who are goi ng to have a direct benefit from a desobstructive procedure. Copyright (C) 2000 S. Karger AG, Basel.