The objective of this paper was to assess the effectiveness of visual
laser ablation of the prostate (
VLAP) using a bare fiber with simultaneous
laser incision of the bladder neck for patients with symptomatic
benign prostatic hyperplasia. Sixty-seven patients with symptomatic
bladder outlet obstruction due to
benign prostatic hyperplasia were entered into a prospective trial where
VLAP was done with
neodymium:
YAG laser, while the bladder neck incision was done with
KTP laser. The
laser was delivered using a bare fiber. There was marked improvement demonstrated at three months post-lasing in symptom score and flow rate. No significant changes were noticed in the subsequent follow-up. However, the addition of the bladder neck incision increased the rate of
retrograde ejaculation without appreciable improvement in symptom score or flow rate when compared to other published data. None of the patients developed bladder neck
contracture.
VLAP, using a bare fiber, in conjunction with
laser bladder neck incision, produces durable improvement in urine flow rate and symptom score in patients with symptomatic
benign prostatic hyperplasia without the development of bladder neck
contracture. This method will reduce the costs of
laser prostatectomy.