Neodymium: YAG Laser Coagulation Prostatectomy: 3 Years of Experience with 227 Patients

Abstract

For 3 years we prospectively followed a cumulative cohort of men who underwent neodymium:YAG laser coagulation prostatectomy to relieve bladder outlet obstruction to determine the safety, efficacy and durability of this procedure. A total of 227 men with symptomatic bladder outlet obstruction was treated with the Urolase side-firing laser fiber between October 15, 1991 and October 15, 1994. Voiding outcomes, including peak urinary flow rates, residual urine volumes and American Urological Association symptom scores, were measured with time, and immediate and long-term complications were assessed. Median patient followup was 26 months (maximum 42). Significant improvement occurred in all measured voiding parameters, including 133% in peak flow rates and 61% in symptom scores 1 year postoperatively. Overall 87% of patients noticed improved quality of life as a result of surgery. Minimum postoperative followup was 6 months in all cases. Complications included prostatitis in 2.6% of patients, urethral stricture in 1.8%, bladder neck contracture in 4.4% and reoperation for residual prostate tissue in 5.3%. Neodymium:YAG laser coagulation of the prostate represents an efficacious surgical intervention for symptomatic bladder outlet obstruction with minimal associated morbidity. Voiding outcomes are durable through 3 years.