Contact laser vaporization of the prostate: one surgeon's experience with 50 consecutive cases

The purpose of this study was to evaluate the efficacy of contact laser vaporization of the prostate as an alternative method of performing transurethral prostatectomy. Fifty patients with bladder outlet obstruction underwent contact laser vaporization of the prostate. Preoperative AUA symptom scores were compared with 3-month postoperative AUA symptom scores. Bleeding, catheter time, average length of hospital stay, and hospital cost are compared to the "gold standard" electrocautery TURP. Prostatic vaporization was performed using a contact laser MTRL-6 round probe, 5 mm in diameter, with the SLT neodymium:YAG (Nd:Yag) contact laser set at 50 W. Procedure time was comparable to that for electrocautery TURP. Average AUA symptom scores were reduced from 22.9 (range, 14-30) preoperatively to 2.1 (range, 0-8) postoperatively. All patients had the foley catheter removed within 24 h; no recatheterizations were required. Of all the patients, 96% were discharged within 24 h; two patients (4%) were not discharged within 24 h because of unrelated coexistent medical problems. All patients were allowed to return to full unrestricted activity within 24 h of discharge. Bleeding was minimal in all cases, with no transfusions required, including three patients in the series on anticoagulant therapy. Hospital costs for the procedure compare favorably to electrocautery TURP. Contact laser TURP using the SLT contact Nd:Yag laser relieved the symptoms of an obstructing prostate comparable to electrocautery TURP. However, these results were achieved with a much shorter hospitalization, a quicker return to full activity, and at a comparable cost.