NEW YORK (Reuters Health) – Analysis of short and long-term outcomes reveals that neodymium:YAG laser ablation of the prostate has very few drawbacks in the treatment of benign prostatic hyperplasia (BPH), according to a report published in the January issue of The Journal of Urology.
Previous findings have suggested that laser therapy provides durable results, but further long-term data were needed to accurately define the role of this approach in men with BPH, the authors note.
Dr. Feridun Sengor and colleagues, from the Haydarpa a Numune Education and Research Hospital in Istanbul, Turkey, assessed the outcomes of 230 BPH patients who underwent laser ablation at their institution since the procedure was introduced in 1993. The study group included 98 patients who had been followed for 5 years or more.
A dramatic improvement in the maximum urinary flow rate, post-void residual urine volume, and American Urological Association symptom score was noted 6 months after the procedure, the authors note. Furthermore, the 5-year results indicate that these outcomes continue to improve.
Early complications were rare and consisted mostly of prostatitis, urinary retention, and bleeding, the investigators state. Late complications were also rare and included bladder neck contracture, urethral stricture, and urinary retention.
The most common complaint following ablation was irritative voiding symptoms. Seventy-four patients complained of this problem in the early postoperative period and 28 reported that the symptoms lasted 4 weeks or more. Five of 153 sexually active men reported erectile impotence, while 20 reported retrograde ejaculation. Nearly 6% of patients required reoperation.
The major disadvantage of laser ablation is the irritative symptoms that often occur, the authors note. However, the procedure is an attractive therapeutic option for patients who desire symptomatic relief but with a lower morbidity rate than is associated with TURP.