[TULIP (transurethral ultrasound-controlled laser-induced prostatectomy)--experiences with over 80 patients]

Of the many methods currently under investigation for the treatment of symptomatic and obstructive benign prostatic hyperplasia (BPH), laser treatment seems the most likely to yield results comparable to those achieved with transurethral resection of the prostate (TURP). Between May 1991 and December 1993 a total of 83 men were treated in our department with the TULIP (transurethral ultrasound-guided laser-induced prostatectomy) device. Within the first year of follow-up there was a marked improvement in both signs and symptoms. The average urinary peak flow increased from 6 to 16 ml/s, the residual urine volume decreased from 218 ml to 36 ml, and the symptom score (assessed against a modified Boyarsky score) decreased from 17 to 4 points. Our experience so far indicates that the advantages of TULIP are minimal blood loss, no post-transurethral resection syndrome, and a low rate of retrograde ejaculation postoperatively. In addition, the procedure can be performed with analgosedation. Disadvantages are the delayed onset of improvement, combined with irritative symptoms in the early weeks after the procedure. In addition, no tissue can be obtained for histological examination, which may be important in the long-term. Randomized prospective studies, including cost-benefit analyses, are needed to check for advantages of TULIP over TURP.