Interstitial laser therapy outcomes in benign prostatic hyperplasia.

Two hundred thirty-nine patients with benign prostatic hyperplasia (BPH) were treated using interstitial laser coagulation (ILC or LITT; laser-induced interstitial thermotherapy), and the long-term results were determined. In this minimally invasive procedure, special laser light guides were inserted into the adenoma tissue in order to achieve primary large-volume coagulation necrosis and secondary shrinking, leaving the urethra intact. The AUA Symptom Scores improved markedly, from an average of 25 pretreatment to an average of 6 at 1 year. Peak urine flow rates improved commensurably, from 8 mL/sec pretreatment to 18 mL/sec at 1 year. Postoperative irritative symptoms occurred occasionally, affecting only 12% of patients. Significant complications were rare, with 4% of patients suffering strictures and 7% retrograde ejaculation. No patients suffered impotence or incontinence. Only 9.6% of patients required retreatment for BPH during 12 months of follow-up. Twelve patients were treated with subsequent transurethral laser incision of the bladder neck in order to shorten the time required for improvement of voiding function.

[1]  S. Hessel,et al.  Technical prerequisites for the interstitial thermotherapy using the Nd:YAG laser , 1990, Photonics West - Lasers and Applications in Science and Engineering.

[2]  H. Lepor,et al.  The efficacy of transurethral resection of the prostate in men with moderate symptoms of prostatism. , 1990, The Journal of urology.

[3]  Rolf Muschter,et al.  Hi-tech of the prostate: interstitial laser coagulation of benign prostatic hypertrophy , 1992, Photonics West - Lasers and Applications in Science and Engineering.

[4]  Robert S. Cowles.  Results after nine months of a prospective randomized study comparing transurethral resection of the prostate and visual laser ablation of the prostate , 1993, Photonics West - Lasers and Applications in Science and Engineering.

[5]  G. Watson,et al.  Laser prostatectomy: our initial experience of a technique in evolution. , 1993, Journal of endourology.

[6]  J J de la Rosette,et al.  Laser ablation of the prostate: experience with an ultrasound guided technique and a procedure under direct vision. , 1994, European urology.

[7]  F. Debruyne,et al.  Transurethral microwave thermotherapy in symptomatic benign prostatic hyperplasia. , 1993, European urology.

[8]  J P Donohue,et al.  High intensity focused ultrasound for the treatment of benign prostatic hyperplasia: early United States clinical experience. , 1994, The Journal of urology.

[9]  J. Golomb,et al.  Effects of prostatectomy onsexual function , 1991 .

[10]  M. Fall,et al.  Transurethral microwave thermotherapy versus transurethral resection for benign prostatic hyperplasia: preliminary results of a randomized study. , 1993, European urology.

[11]  R K Babayan,et al.  Transurethral ultrasound-guided laser-induced prostatectomy: National Human Cooperative Study results. , 1993, The Journal of urology.

[12]  Yukio Homma,et al.  Transurethral ultrasound-guided laser-induced prostatectomy (TULIP) for benign prostatic hyperplasia: clinical utility at one-year follow-up and imaging analysis. , 1994, Urology.

[13]  A. Shanberg,et al.  Extensive neodymium-YAG photoirradiation of the prostate in men with obstructive prostatism. , 1994, Urology.

[14]  A. J. Costello,et al.  Treatment of prostatic obstruction with neodymium:YAG laser , 1992, Photonics West - Lasers and Applications in Science and Engineering.

[15]  C. Ogden,et al.  Sham versus transurethral microwave thermotherapy in patients with symptoms of benign prostatic bladder outflow obstruction , 1993, The Lancet.

[16]  K. Rothenberger,et al.  [Interstitial laser coagulation of benign prostatic hyperplasia]. , 1993, Der Urologe. Ausg. A.

[17]  T. Senge,et al.  [TULIP--transurethral ultrasound-controlled laser-induced prostatectomy: an alternative to TURP?]. , 1993, Der Urologe. Ausg. A.

[18]  A. Costello,et al.  Laser ablation of the prostate in patients with benign prostatic hypertrophy. , 1992, British journal of urology.

[19]  K. Shinohara,et al.  Transurethral evaporation of prostate (TUEP) with Nd:YAG laser using a contact free beam technique: results in 61 patients with benign prostatic hyperplasia. , 1994, Urology.

[20]  Brian S. Shaffer,et al.  Preliminary results of laser ablation of the prostate versus TURP: a randomized study , 1993, Photonics West - Lasers and Applications in Science and Engineering.

[21]  G. Watson.  Heat and the prostate. , 1993, European urology.

[22]  W. Mebust,et al.  Transurethral Prostatectomy: Computerized Analysis of 2,223 Consecutive Cases , 1974 .

[23]  R. van Mastrigt,et al.  Improved indication and followup in transurethral resection of the prostate using the computer program CLIM: a prospective study. , 1992, The Journal of urology.

[24]  G. Scannapieco,et al.  Transurethral ultrasound-guided laser-induced prostatectomy. Objective and subjective assessment of its efficacy for treating benign prostatic hyperplasia. , 1994, European urology.

[25]  A. Flood,et al.  Mortality, morbidity and complications following transurethral resection of the prostate for benign prostatic hypertrophy. , 1992, The Journal of urology.

[26]  R. Bruskewitz,et al.  Symptom analysis and uroflowmetry 7 years after transurethral resection of the prostate. , 1989, The Journal of urology.