Transurethral ultrasound-guided laser-induced prostatectomy (TULIP): past, present, and future.

The TULIP system was the first apparatus designed specifically for laser ablation of the prostate. Laser energy is delivered under ultrasound guidance with the probe moved distally from the bladder neck at the rate of 0.5 to 1 mm/sec. The aim is to produce a deep level of coagulation necrosis. Postoperatively, patients have a suprapubic catheter until they can void comfortably. As of 1994, 2-year results showed a 69% reduction in the mean Boyarsky symptom score (N = 57) v 63% at 6 months (N = 212) and a mean increase in the peak urine flow rate of 68% (N = 46) v 59% at 6 months (N = 195). At present, it is not clear whether TULIP will become commercially available in the United States.