Interstitial laser coagulation for management of benign prostatic hyperplasia: Long‐term follow‐up

Abstract

Aim : We evaluated the long-term results of transurethral interstitial laser coagulation in the treatment of benign prostatic hyperplasia (BPH) with up to 9 years of follow up at the Kurashiki Central Hospital and determined the patient characteristics that predict a favorable outcome. Methods : From December 1993 to May 1997, a total of 82 patients were enrolled in the present study. Subjective and objective voiding parameters were collected from medical records and a selfadministered questionnaire was sent to the patients. Kaplan-Meier plots were constructed to assess the risk of retreatment.Results : The mean follow-up period was 48.4 months (range, 3-108 months). A total of 59 patients (72%) did not need any additional treatment at 12 months and 30 patients (37%) did not require additional treatment during the entire follow-up period. A total of 29 patients (35%) were retreated during follow-up. Transurethral prostate resection (TURP) was performed in 18 patients (22%). The remaining 11 patients (13%) were offered additional pharmacotherapy. The minimum and median retreatment-free durations were 3 and 14 months, respectively. Seven patients died and 17 were lost to follow-up. Men aged 71 years or older had greater likelihood of requiring retreatment than those younger than 71 years ( P = 0.0397). No significant differences were noted in the other baseline characteristics. Among postoperative parameters, a rate of decrease of the International Prostate Symptom Score of the patient of lower than 60% and a rate of decrease in patient quality of life of lower than 50% at 3 months were associated with greater likelihood of retreatment ( P = 0.0083 and P = 0.0006, respectively). Conclusions : Interstitial laser coagulation is effective for the treatment of BPH. Good long-term results and an acceptably low retreatment rate render this modality an effective alternative to TURP, especially for younger patients. Short-term improvement of subjective symptoms was predictive of favorable long-term outcome.

Combination of Channel-TURP and ILC versus Standard TURP or ILC for Elderly with Benign Prostatic Hyperplasia: A Randomized Prospective Trial

“…However, the ILC technique does not immediately remove prostate tissue and this intraprostatic lesion may result in secondary atrophy and regression of prostatic lobes within 4-12 weeks. This technique usually leads to postoperative complications including acute urinary retention and irritative voiding [24][25][26] because the heat treatment is closely related to postoperative edema which may worsen the obstructive symptoms and result in urinary retention [27] . The median time in which urinary retention resolves is about 45 days following ILC [21] .…”

New laser treatment approaches for benign prostatic hyperplasia

“…These studies found that the main advantage of ILC is that it offers decreased operative morbidity compared with TURP. However, the postoperative complications are higher with ILC, with prolonged catheterization times, greater incidence of irritative symptoms, higher infection rates, and less improvement in peak urinary flow than TURP [3][4][5] (Table 2). As a result, ILC has become less popular and is only recommended for selected BPH patients who are suffering from coagulation disorders.…”

“…Although the popularity of ILC has declined over the past few years, several studies have recently been reported [3][4][5][6]. These studies found that the main advantage of ILC is that it offers decreased operative morbidity compared with TURP.…”

Long-Term Results of Interstitial Laser Coagulation for the Treatment of Benign Prostatic Obstruction

“…Two studies on ILC explicitly addressed the question of predictive factors for treatment failure [4,11]. Muschter et al [11] in a rather large analysis did not find any predictive factors.…”

“…Muschter et al [11] in a rather large analysis did not find any predictive factors. Terada et al [4] identified an age of 71 years or older and percentage decrease of QOL at three months as independent significant postoperative parameters. Residual volume preoperatively was not identified as significant parameter.…”