[Laser prostatectomy--image analysis by transurethral ultrasonography].

Background: Conventional transurethral Nd:YAG laser ablation of the prostate does not significantly reduce the volume of prostate and patients frequently experience post-operative urinary retention. Thus in the present study, prostatic tissue was extensively vaporized with laser fiber to produce a definite cavity during the operation.

Methods: Between August 1993 and April 1995, laser prostatectomy utilizing Ultraline was carried out on 91 patients with BPH, 38 of these patients had histories of urinary retention. The size and form of the prostate were examined by transurethral ultrasonography (TUUS) prior to surgery and ablation was conducted based on the findings. The results were checked by TUUS a second time.

Results: Operating time was 84.1 minutes on the average including the time for systematic needle biopsy and cystostomy for irrigation. Total irradiation dose was 132,035J on the average. The catheter was removed at an average 5.8 days postoperatively. I-PSS was noted to improve from 15.3 to 5.6, maximum flow rate, 9.3 to 15.8 ml/s, average flow rate, 4.6 to 9.2 ml/s and residual urine, 76.0 to 15.9 ml. The volume of the prostate was reduced by 31.5% (39.3 to 26.6 ml) and the patients could urinate for more than a year without discomfort. No serious complications were encountered though epididymitis was noted in 5 and urethral stricture in 10 patients.

Conclusion: The present laser prostatectomy is less invasive than TUR-P and the results might be equal to it.