Ultrasonographic and pathologic changes in the prostate of patients with benign prostatic hyperplasia after transurethral balloon laser therapy.

Twenty-seven patients with benign prostatic hyperplasia (BPH) were treated with a transurethral flexible laser balloon (PROSTALASE) under ultrasound guidance. Three months after treatment, 22 (82%) of the patients showed a 50% or greater decrease in the AUA Symptom Score. The average uroflow rate, peak uroflow rate, and postvoiding residual urine volume also showed significant improvement. Ultrasonography showed that the prostatic volume had decreased by 17% (8%-37%). Also, a circular hyperechoic zone about 3 cm in diameter was noted around the prostatic urethra. The prostatic tissue in the hyperechoic zone was sampled by transperineal needle biopsy under transrectal ultrasound guidance, and histopathologic examination showed degenerative necrosis. The necrotic tissue was gradually absorbed, resulting in prostatic shrinkage at around the third month. These results suggest that clinical improvement, both subjective and objective, is brought about by this therapy.