Transurethral Holmium Laser Resection of the Prostate

PURPOSE: We evaluated the efficacy of the holmium:YAG laser for transurethral endoscopic prostatectomy for benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: We treated 103 patients with BPH with holmium:YAG laser resection of the prostate. A high power holmium laser generating a maximum of 60 or 81 W. was used in a pulsed mode, applying energy directly to prostatic tissue via a forward firing 550 micron. fiber transurethrally under direct vision. Treatment outcome was evaluated by the International Prostate Symptom Score, quality of life score, maximum flow rate and post-void residual urine volume. We also compared holmium laser surgery and transurethral resection of the prostate for operative factors, such as surgical duration, bleeding volume and catheterization time. RESULTS: Average symptom score, quality of life score, peak flow rate and post-void residual significantly improved at 1 week, 1 month and 3 months postoperatively, with improvement maintained up to 36 months postoperatively in the holmium:YAG group. Intraoperative bleeding volume was significantly lower and catheterization time was significantly shorter for holmium:YAG than for transurethral prostatic resection. Use of the holmium laser caused no complications. CONCLUSIONS: Because of its effectiveness and safety holmium:YAG resection is a viable potential surgical alternative for symptomatic BPH. The holmium:YAG laser has been verified to be useful for many purposes in urology.