Laser ablation of the prostate: experience with an ultrasound guided technique and a procedure under direct vision.

Twenty-four patients with benign prostatic hyperplasia were treated with the Nd:YAG laser. We review our experience with two different techniques: the ultrasound-guided transurethral laser-induced prostatectomy (TULIP) and the visual laser ablation of the prostate (VLAP). Our experience with these two different laser systems shows that the treatment is relatively simple, speedy and performed with virtually no blood loss. The results, of both the TULIP and VLAP procedures, are excellent. The symptom scores decrease from 43 to 19 (TULIP) and 48 to 9 (VLAP). Furthermore, there is a marked increase in average uroflow from 7.9 to 18.6 ml/s (TULIP) and from 8.1 to 18.0 ml/s (VLAP). The patients with the TULIP procedure, however had more pronounced posttreatment complaints. These patients more often received antibiotics. Laser therapy of the prostate, although still in its infancy, gives excellent results and has substantial advantages over conventional transurethral resection of the prostate (TURP). Laser therapy may replace TURP within several years.