Side firing Neodymium:Yag laser prostatectomy: six years of experience with 170 patients.

OBJECTIVES

To evaluate the results and complications in 170 patients with symptomatic benign hyperplasia who underwent laser prostatectomy focusing on six month and long-term results.

METHODS

A total of 170 patients underwent side firing Neodymium:Yag laser prostatectomy between January 1995 and February 2001 of whom 152 and 82 were available after 6 months and 3 years follow-up respectively. Evaluations were done by American Urological Association (AUA) symptom score, peak urinary flow rate, residual volumes and immediate and long-term complications were assessed.

RESULTS

Median patient follow-up period was 34.1 months (16-70). After 6 months the mean AUA score reduced from 20.2 to 8.2 and found as 9.4 in patients who completed 3 years follow-up. Post voiding urine volume decreased from 110 ml to 46 ml at 6 months and found as 60 ml after 3 years. Peak urinary flow rate increased from 3.4 to 16.4 ml per second after 6 months and found as 14.8 ml per second after 3 years. The overall complications of 170 patients in early period included urinary retention after catheter removal in 6 (3.52%), early bleeding in 2 (1.17%), late bleeding in 1 (0.58%). Late complications included urethral stricture requiring internal urethrotomy in 12 (7.8%), bladder neck contracture in 4 (2.6%) and repeated laser prostatectomy after 2 years in 10 (5.88%) patients.

CONCLUSION

Side firing Neodymium:Yag laser prostatectomy offers a safe and effective treatment for bladder outlet obstruction due to benign hyperplasia with minimal associated morbidity.