Safety and efficacy of quartz head contact laser ablation for large prostates using 980-nm laser: a comparative prospective study against that for small- and medium-sized prostates.

Objective: To examine the safety and efficacy of quartz head laser ablation of the prostate (QLAP) in the treatment of large and huge prostates as compared with small- and medium-sized ones.

Materials And Methods: Two hundred forty-two patients with lower urinary tract symptoms secondary to benign prostatic hypertrophy (BPH) were included in the study, of which 210 patients were evaluable. Patients were divided into 2 groups: group A: patients with BPH volume of <80 mL (120 patients) and group B patients with gland size ≥80 mL. All patients were subjected to QLAP procedure. They were evaluated perioperatively and 1 week; 1, 3, and 6 months; and every 6 months thereafter postoperatively.

Results: Patients' demographics and preoperative data were similar except for the gland size (group A, 54.96 ± 15.49 mL [20-79 mL] and group B, 124.68 ± 40.88 mL [80-233 mL]). Operative time corrected to gland volume was shorter in group B. Only 10% of all patients needed 2 fibers. There was no significant electrolyte change in both groups. Hemoglobin has minimally decreased in both groups but was statistically significant. Group B outcome was significantly better regarding International Prostate Symptom Score, International Prostate Symptom Score quality of life, and uroflowmetry. Prostate size decreased by 47 ± 2% and 62.7 ± 2% at 6 months post operatively for groups A and B, respectively.

Conclusion: QLAP demonstrated good efficacy and safety in treating large and huge BPH. It possessed no added risk as compared with small prostates. It can be a good alternative to open prostatectomy especially in patients with significant comorbidities.