Long-term Effect of Visual Laser Ablation of the Prostate: According to Follow-up Period

Byun, Dong Won; Chung, Woo Sik; Shim, Bong Suk

Abstract

PURPOSE: Many techniques have evolved to treat benign prostatic hyperplasia (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 also been used 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.
MATERIALS AND METHODS
85 patients with BPH underwent an initial operation, where a VLAP was performed with a neodymium:YAG laser. 65 patients, 6 months after the operation, and 25, 6 years after the operation, were available for follow-up studies. Voiding outcomes, including peak urinary flow rates, residual urine volumes and American Urological Association (AUA) symptom scores, were measured over time.
RESULTS
6 months after the operation significant improvement was seen in the prostatic size, maximal flow rate and post-void residual volume. However, no significant statistical improvement in these parameters was noticed in the subsequent 6 year follow-up (p>0.05). Comparisons of the mean AUA scores, before the operation, and 6 months (p<0.05) and 6 years (p>0.05) after, showed significant differences for the different times. With regard to the quality of life due to the urinary symptoms, 87.7% of patients 6 months, and 72.7% 6 years after the operation felt more than mildly satisfied.
CONCLUSIONS
There have been numerous reports on the efficacy of VLAP, which show its many advantages, such as low morbidity, high simplicity and good short-term effect. However, according to this study, the long-term therapeutic effect of VLAP was poor, but its exact role for the treatment of BPH remains to be determined.