Comparative study of transurethral laser prostatectomy versus transurethral electroresection for benign prostatic hyperplasia

Background: Transurethral resection of the prostate (TURP) is the gold standard treatment for benign prostatic hyperplasia (BPH). Recently, less invasive transurethral laser prostatectomy, such as visual laser ablation (VLAP) or interstitial laser coagulation (ILCP), have been developed. Herein, we investigated the efficacy of VLAP and ILCP compared to TURF. Methods: A total of 80 patients with BPH were treated: 20 patients by VLAP, 30 patients by ILCP and 30 patients by TURF. All patients were followed up for 12 months after their operations. Treatment outcomes were evaluated by four different criteria: (i) the International Prostatic Symptom Score (I-PSS), (ii) the maximum flow rate (Q(max)) (iii) postvoided residual urine volume before treatment and one, three, six and 12 months after treatment, and (iv) prostatic volume before operation and three and six months postoperatively. Results: The I-PSS, Qmax and residual urine volume were significantly improved compared to baseline levels and the improvement continued for 12 months in the three groups: for I-PSS (P < 0.001 in the VLAP group and P < 0.0001 in the ILCP and TURF groups), Q(max) (P < 0.001 in the VLAP and ILCP groups, and P < 0.0001 in the TURF group), residual urine volume (P < 0.01 in the VLAP group and P < 0.0001 in the ILCP and TURF groups). Significant reduction of the prostatic volume was recorded only in the ILCP and TURF groups (P < 0.001). Conclusion: Visual laser ablation and ILCP can be good alternative treatments for BPH. Visual laser ablation provides good outcomes in patients with small-sized BPH and with risk factors such as heart disease or anticoagulation therapy.