Long Term Follow-Up after Visual Laser Ablation of the Prostate

There are many new techniques that have been developed to treat benign prostatic hypertrophy (BPH). These techniques attempt to achieve the clinical benefits of transurethral resection of the prostate, while trying to decrease the morbidity associated with this procedure. Visual laser ablation of the prostate (VLAP) has been also known as an effective treatment modality of BPH. The objective of this paper was to evaluate the long term effect of VLAP for patients with symptomatic BPH.

Seventy four patients with BPH were entered into a initial trial where VLAP was done with neodymium : YAG laser. Fifty seven patients at 6 months after operation and twenty two patients at 6 years after operation were possible to do follow-up study. Voiding outcomes, including peak urinary flow rates, residual urine volumes and American Urological Association (AUA) symptom scores, were measured with time.

There was significant improvement demonstrated at 6 months after operation in prostatic size, maximal flow rate and post-void residual volume. But no significant statistical improvement of these all parameters was noticed in the subsequent 6 years follow-up (p> 0.05). Comparisons among means of AUA score before operation, and 6 months (p<0.05) and 6 years (p>0.05) after operation showed significant differences in different times. In quality of life due to urinary symptoms, 87,7% of patients at 6 months after operation and 72.7% of patients at 6 years after operation felt more than mild satisfied.

There are lots of reports on the efficacy of VLAP, which showed many advantages of bloodless, low morbidity and simplicity. The laser, including VLAP was used in a variety of ways to treat symptomatic BPH. According to this studies, the long term therapeutic effect of VLAP is uncertain. So we must carefully decide VLAP as the treatment modality for BPH. Its exact role in the armamentarium for the treatment of BPH remains to be determined.