Initial Experience of the Effect of Laser CHRP (Coagulation and Hemostatic Resection of the Prostate) for Benign Prostatic Hyperplasia

Kim, Nam Kug; Nam, Sam Keuk; Kim, Soon Chan

Abstract

Laser CHRP (coagulation and hemostatic resection of the prostate) is a new acceptable treatment modality for benign prostatic hyperplasia. A total of 14 patients with symptomatic bladder outlet obstruction due to benign prostatic hyperplasia was entered into a prospective trial of laser prostatectomy performed with the right- angle firing neodymium: YAG laser fiber and the contact tip firing neodymium: YAG laser fiber at 60 watts power setting. Mean estimated prostatic weight was 36.3gm. Six patients (43%) were in urinary retention requiring catheterization before treatment. Mean energy delivery was 34,442 joules (range 25,360 to 45,000) with a mean operative time of 41 minutes. Efficacy of treatment was assessed at 1, 6 and 12 months postoperatively by Madsen symptom scores, peak urinary flow rates and ultrasonic assessment of prostatic volume. At preoperative baseline the mean symptom score was 19.9, mean peak urinary flow rate 8.6cc per second, and mean ultrasonic assessment of prostatic volume 36.3gm. At 1 year postoperatively mean symptom score was 6.1, mean peak urinary flow rate was 18.3cc per second and mean ultrasonic assessment of prostatic volume was 26.4 gm. One patient required retreatment for residual tissue. There was one bladder neck contracture requiring incision.