Laser prostatectomy versus transurethral resection of prostate in the treatment of benign prostatic hyperplasia

OBJECTIVE: To assess the effectiveness of laser-prostatectomy compared with transurethral resection of prostate (TURP).

METHODS: This randomized clinical trial with one year follow-up, was conducted on 87 patients with benign prostatic hyperplasia (BPH) at Shohada-e-Tajrish Hospital, Tehran, Iran, from 1999 to 2003. Fifty-two patients underwent TURP and 35 patients were treated by non-contact laser prostatectomy using ND: YAG laser at 40-60 watt power and 13000-29000 jules energy settings.

RESULTS: Comparing variables of urinary maximum flow and residue, changes of urine volume and severity of symptoms during consequent periods of 3, 6 and 12 months after the operation in 3 groups revealed that differences in maximum urinary flow changes were significant only in the sixth month (p<0.05). Also, changes in the severity of symptoms before and after the operation showed more decrease in the TURP group during all 3 periods of follow-up (p=0.01). In the laser prostatectomy group duration of operation (p=0.01), amount of fluid used during the operation (p<0.001) and duration of bed rest (p<0.001) were less than those of the TURP group.

CONCLUSION: Laser prostatectomy can decrease duration of operation, duration of bed rest and pathogenesis following the operation in patients. Although changes in the severity of symptoms are more pronounced in TURP patients, changes in urodynamic indexes are similar in both groups.