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[Therapy by endoscopic laser for prostatic obstruction]

T A Mc Nicholas1, M Aslam, J Van Waeyenbergh

  • 1Department of Urology, Lister Hospital North Herts Trust Stevenage, Hertfordshire, UK.

Journal D'Urologie
|January 1, 1993
PubMed
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Laser prostatic coagulation offers a safe alternative to traditional surgery for benign prostatic enlargement (BPH). This study shows significant improvements in urinary flow and symptom scores with minimal complications.

Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Laser Therapeutics

Background:

  • Transurethral resection of the prostate (TURP) is a common treatment for benign prostatic enlargement (BPH).
  • There is ongoing research for alternative treatments to TURP, including laser therapies.
  • Laser prostatic coagulation is being explored as a less invasive option.

Purpose of the Study:

  • To evaluate the efficacy and safety of prostatic laser coagulation using endoscopic beam deflection devices (Prolase II).
  • To assess outcomes in patients with bladder outlet obstruction (BOO) due to BPH who were not suitable for TURP.

Main Methods:

  • 25 patients with symptomatic BPH and BOO underwent prostatic laser coagulation.
  • Preoperative assessments included clinical examination, Prostate Specific Antigen (PSA) assay, and transrectal ultrasound (TRUS).

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  • Post-procedure, patients were monitored for urinary flow rate, symptom scores (IPSS), catheterization duration, and complications.

    • Main Results:

    • Mean peak flow rate improved from 7.6 ml/s to 15.3 ml/s at 3-month follow-up.
    • International Prostate Symptom Score (IPSS) decreased from a mean of 21 to 10.
    • Mean suprapubic catheter (SPC) drainage was 11 days, with a mean inpatient stay of 4.5 days.
    • Minimal blood loss and no significant complications were reported.

    Conclusions:

    • Prostatic laser coagulation is a safe and effective alternative for BPH treatment, particularly for patients who cannot undergo TURP.
    • The procedure leads to significant improvements in urinary flow and reduction in obstructive symptoms.
    • Patients experienced an initial period of irritability, but overall symptomatic improvement was achieved.