VISUAL LASER-ABLATION OF THE PROSTATE (VLAP) WITH BARE FIBER IN CONJUNCTION WITH LASER BLADDER NECK INCISION IN THE TREATMENT OF PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA (BPH)

The objective of this paper was to assess the effectiveness of visual laser ablation of the prostate (VLAP) using a bare fiber with simultan eous laser incision of the bladder neck for patients with symptomatic benign prostatic hyperplasia. Sixty-seven patients with symptomatic bl adder outlet obstruction due to benign prostatic hyperplasia were ente red into a prospective trial where VLAP was done with neodymium:YAG la ser, while the bladder neck incision was done with KTP laser. The lase r was delivered using a bare fiber. There was marked improvement demon strated at three months post-lasing in symptom score and flow rate. No significant changes were noticed in the subsequent follow-up. However , the addition of the bladder neck incision increased the rate of retr ograde ejaculation without appreciable improvement in symptom score or flow rate when compared to other published data. None of the patients developed bladder neck contracture. VLAP, using a ban fiber, in conju nction with laser bladder neck incision, produces durable improvement in urine flow rate and symptom score in patients with symptomatic beni gn prostatic hyperplasia without the development of bladder neck contr acture. This method will reduce the costs of laser prostatectomy.