Treatment of a benign prostatic hyperplasia by Nd:YAG laser - own experience

To evaluate the effectiveness and safety of visual laser ablation (VLAP) and interstitial laser coagulation (ILCP) versus transurethral resection of the prostate (TURP).

Altogether 259 consecutive patients with symptomatic benign prostatic hyperplasia (BPH) were treated by VLAP (n = 117), ILCP (n = 30) or TURP (n = 112). VLAP was carried out using both contact and noncontact techniques, whereas ILCP using the technique described by Muschter. The results were obtained at a mean follow-up of 23 months (from 6 to 48 months). IPSS, quality of life, maximum flow rate, and residual urine were evaluated preoperatively and at 3 and 6 months after operation in all patients. The results at 12, 24 and 48 postoperative months are available for 122, 86 and 72 patients, respectively.

Mean values of all outcome parameters improved during 6 postoperative months (p<0.05) in all groups of patients and subsequently remained unchanged during the 4-year postoperative period. There were no serious postoperative complications in the laser groups. Very good and good results were obtained in 71.3% patients after VLAP, in 89.3% patients after ILCP and 81.4% patients after TURP.

Both VLAP and ILCP are safe methods with low risk of complications, however, they are less effective than TURP, which remains the gold standard for BPH patients requiring surgical treatment