Visual laser coagulation for benign prostatic hyperplasia

A total of 28 patients with symptomatic bladder outlet obstruction due to benign prostatic hyperplasia were treated by visual laser coagulation (VLAP) performed with the Myriadlase side-firing neodymium: YAG laser fibre at 40 watts power. The treatment was performed as an outpatient procedure using intraurethral gel anaesthesia and light intravenous sedation and analgesia. Prostatic volume was 32 g and 650 joule per gram prostatic tissue was administered. The patients were evaluated at mean 9.2 weeks. The mean operative time was 34 minutes. The procedure was very gentle, all patients tolerated it well and there was no bleeding. Most patients experienced some dysuria for three to four weeks after the procedure, two had severe symptoms. Two patients remained in retention and required transurethral resection. The rest expressed subjective satisfaction with the results. Peak urinary flow increased from mean 9.0 ml/sec preoperatively to 15.4 ml/sec; a mean increase of 78%. One patients developed clinical urinary tract infection. There were no other complications of clinical significance. 19 refs., 1 fig