Visual laser ablation of the prostate: clinical experience in 108 patients

Visual laser ablation of the prostate was performed on 108 patients (ages 44 to 84 years) as an outpatient procedure from May 1992 to October 1992. Preoperatively, the patients underwent digital rectal examinations, determination of prostate specific antigen levels and transrectal ultrasound guided biopsies when necessary to rule out the presence of prostate cancer. The Urolase laser fiber delivery system was used to transmit laser energy from a neodymium: YAG generator. For the 97 patients with preoperative and postoperative American Urological Association symptom index testing, scores decreased by an average of 12.59 (p < 0.001). For the 75 patients with preoperative and postoperative uroflow rates an average increase of 4.92 ml. per second (p < 0.001) was noted following the procedure. Only 3 patients required hospitalization for an average of 1.33 days. No patient required a blood transfusion. There have been no fluid or electrolyte abnormalities following visual laser ablation of the prostate. There have been no recognizable urethral strictures, deaths or postoperative sepsis. Only 3 patients experienced retrograde ejaculation. We found visual laser ablation of the prostate to be a cost-effective and less morbid alternative to traditional transurethral resection of the prostate.