Visual laser ablation of the prostate: efficacy evaluated by urodynamics and compared to TURP.

Abstract

To determine the efficacy of visual laser ablation of the prostate (VLAP) in comparison to conventional transurethral resection of the prostate (TURP). 133 patients with benign hyperplasia of the prostate (BPH) were treated by VLAP (n = 90) or TURP (n = 43). International prostate symptom score (IPSS), uroflow, residual urine and grade of obstruction determined by pressure flow studies were evaluated before and after treatment. The VLAP was performed by means of a side firing laser fiber under visual control and using a Nd:YAG laser as energy source. VLAP could improve IPSS, uroflow and residual urine in all patients. However, the obstruction grade was lowered to normal only in patients with prostates smaller than 50 ml, whereas TURP was able to eliminate the obstruction in all patients. VLAP can be offered as an alternative to TURP in patients with BPH as long as the prostate volume is not bigger than 50 ml.