Neodymium:YAG laser ablation of the prostate gland--acute perioperative morbidity and short-term outcome.

Twenty-three patients with symptomatic bladder outlet obstruction due to benign prostatic hyperplasia were successfully treated with laser prostatectomy using the Urolase right-angle firing neodymium: Yttrium Aluminum Garnet laser fiber. Most of the patients had health problems of moderate severity. Their conditions were compared preoperatively and 3 mo postoperatively. Symptom scores decreased from an average of 23.9 to 7.0. Symptomatic relief was achieved in 95.7% of patients. Peak urinary flow rates increased from an average of 6.4 to 17.0 ml/s. The residual urine decreased from an average of 45.2 to 22.9 ml. The volume of the prostate gland measured by sonography decreased from an average of 32.8 to 25.7 ml. Virtually no blood loss was noted intraoperatively. Acute urinary retention occurred immediately following removal of the catheter in 3 out of 17 (17.6%) patients without a percutaneous cystostomy tube. Acute epididymitis developed in 5 out of 20 (25.0%) patients without bilateral vasectomy. Based on these results, laser prostatectomy may be concluded to be a safe and effective alternative to standard transurethral resection of the prostate gland, particularly in the case of high-risk patients.