Noncontact sidefire laser ablation of the prostate.

Continuing experience with Nd:YAG noncontact sidefiring laser fibers over the past 4 years has shown encouraging results. Thus far, of the 198 patients treated with the 60 W/60 seconds technique since October 1990, a total of 74 were available for long-term evaluation (69 at 12 months and 29 at 24 months). The AUA Symptom Scores, Qmax (peak uroflow rates), and postvoiding residual urine volumes demonstrated marked improvement. The complications included 16 instances of recurrent obstructive symptoms necessitating revision. Three patients suffered urinary tract infections, two patients developed bladder neck stenosis, four anticoagulated patients with clot retention required blood transfusions, and three patients had epididymoorchitis. Follow-up at 12 and 24 months showed sustained reduction in AUA Symptom Scores and maintained improvement of the peak flow rates and residual volumes. These results demonstrate the safety and clinical applicability of laser ablation of the prostate and its potential usefulness as a less invasive therapy for benign hyperplasia.