Transurethral balloon laser thermotherapy for symptomatic benign prostatic hyperplasia: preliminary clinical results

Between April 1993 and May 1994, 66 patients were treated with transurethral balloon laser thermotherapy (TUBAL-T) for the relief of bladder outlet obstruction secondary to benign prostatic hyperplasia. TUBAL-T, with a urethral cooling system, employs a balloon catheter and irradiating laser through 360 degrees to produce deep coagulation and necrosis of the prostatic tissue while preserving the urethral mucosa. The procedure was implemented under local topical anesthesia. Baseline AUA Symptom Scores, peak uroflow rates, postvoiding residual urine volumes (PVR), and prostatic volumes were measured before and at 1, 3, 6, and 12 months after treatment. The mean symptom score decreased from 18.8 preoperatively to 9.8, 6.9, 7.4, and 4.8 at 1, 3, 6, and 12 months, respectively. The mean peak uroflow rate increased from 6.4 mL/sec to 9.1, 11.2, 10.1, and 10.4 mL/sec at 1, 3, 6, and 12 months, respectively. As for the mean PVR, statistically significant reductions were clearly observed at 3 and 6 months after treatment. However, at 1 and 12 months, the difference was not statistically significant. In follow-up for as long as 12 months after the procedure, 23 of 26 patients (88%) showed an improvement of 50% or more in the AUA Symptom Scores. Of 20 available patients, 12 (60%) showed an improvement of 50% or higher in the peak uroflow rates, and 10 (50%) showed an improvement of 50% or higher in PVR. The mean prostatic volume reductions at 3, 6, and 9 months were 12%, 16%, and 14%, respectively. The serum prostate specific antigen concentration increased to four times the baseline concentration on the 7th day.(ABSTRACT TRUNCATED AT 250 WORDS)