Efficacy of laser prostatectomy at 2-years' follow-up

A total of 32 patients with symptomatic benign prostatic hyperplasia were treated with the right-angle firing neodymium:YAG laser fiber at a 60 W power setting. All these patients represented a high operative risk (ASA score > or = 3) and were excluded by the anesthesiologist for classic surgical treatment. Twenty-six patients were followed at least 24 months; the six remaining patients died of intercurrent disease. Efficacy of treatment was assessed at 3, 6, 12, 18, and 24 months postoperatively by International Prostatic Symptom Scores, peak urinary flow rates, prostatic volume, and radiographic or endoscopic imaging of the prostatic urethra. The mean preoperative symptom score was 25, the mean peak urinary flow rate 7.6 mL/sec, and mean prostatic volume 31 cc. At 2 years postoperatively, the mean symptom score was 5, the mean peak urinary flow rate was 19.3 mL/sec, and the mean prostatic volume was 18 cc. In two elderly patients, in spite of a significant improvement of symptomatology and peak flow rate, a surprisingly obstructed prostatic urethra was found endoscopically.