[TULIP--transurethral ultrasound-controlled laser-induced prostatectomy: an alternative to TURP?]

Transurethral resection of the prostate (TURP) is the most effective treatment for prostatic obstruction secondary to benign prostatic hyperplasia (BPH). This procedure has a high success rate with a very low mortality rate. Over the last 30 years, however, an unchanged morbidity rate of about 20% following TURP has been reported in the literature. In addition, haemorrhage requiring blood transfusion may occur in 6.5-22% of cases, and 68-92% of sexually active men have retrograde ejaculation following TURP. The side-effects and complications associated with TURP have led to the search for alternative therapies. The TULIP system represents a new treatment modality. TULIP is an acronym for transurethral ultrasound-guided laser-induced prostatectomy. The basic TULIP system consists of an ultrasound imager and a 20-F transurethral probe with an ultrasound transducer and a laser window at the distal end. Under ultrasound guidance laser treatment results in a coagulation necrosis effect in the hyperplastic prostate tissue. Coagulation necrosis is basically a bloodless tissue removal procedure as the tissue subsequently sloughs away in the fine particles during spontaneous micturation within 4-6 weeks after the procedure. Early results obtained in the first 18 patients with symptomatic, obstructive BPH treated by TULIP and with a follow-up of 6 weeks to 6 months demonstrate a significant improvement in both subjective and objective symptoms. The peak flow rate increased by up to 142% on average; the residual volume decreased by up to 75%; and there was a 77% decrease in average symptom scores compared with preoperative scores.(ABSTRACT TRUNCATED AT 250 WORDS)