Interstitial laser coagulation in the management of lower urinary tract symptoms suggestive of bladder outlet obstruction from benign prostatic hyperplasia: long‐term follow‐up

The first two papers in this section are on the topic of laser therapy for BPH. This is obviously a much‐visited topic, but these papers help to throw further light on the subject. Is the laser the best way of treating this condition? We need more evidence to answer this question, and hopefully we will be able to give our patients the correct response when they ask us, based on papers such as these. OBJECTIVE To evaluate the long‐term effects, including durability, of interstitial laser coagulation (ILC) in patients with symptomatic benign prostatic hyperplasia. PATIENTS AND METHODS In all, 49 men (median age 68 years, range 52–80) were treated with ILC; 22 men were assessed for a median (range) of 54 (46–61) months. Information on the timing and type of re‐treatment were collected for the remaining patients. RESULTS The median (quartiles) International Prostate Symptom Score decreased from 22 (19–28) at baseline to 13 (5–21), a decrease of 41%. The peak urinary flow increased by 20% to 10.2 (8.7–12.9) mL/s. Twenty‐two patients were re‐treated (by any type) after ILC, giving a re‐treatment rate of 50%. CONCLUSION There were moderate effects on voiding variables and a high re‐treatment rate during the long‐term follow‐up after ILC. It seems reasonable that the use of ILC is restricted to selected, high‐risk patients.