Prostatic aperture resulting from visual laser ablation: classification system based on follow-up endoscopy.

Abstract

To study the evolving prostatic aperture created by visual laser ablation (VLAP), we performed 38 video-endoscopies in 24 men with prostatism at various intervals 2 weeks to 1 year after treatment. Complete healing was generally observed within 3 to 4 months, never before 6 weeks; and in some patients, tissue sloughing was still apparent beyond 6 months. By review of the cystoscopic findings and video hard copies, three independent observers classified the healed prostatic apertures with great uniformity into one of four categories: (I) minimal change (lateral lobes still meet in midline throughout gland length) (N = 3); (II) minor aperture (opening less than 50% of cystoscopic field over less than 50% of gland length) (N = 5); (III) major aperture (opening more than 50% of cystoscopic field over more than 50% of gland length) (N = 11); and (IV) full ablation (nearly complete replacement of lobar configuration with a general concavity) (N = 5). Clinical outcomes (symptom scores, uroflow rates) matched with follow-up cystoscopic categories but not with any other readily identifiable measures. The four-category system proved to be simple, reproducible, and clinically relevant. If a standardized tissue aperture is the ultimate aim of new methods to ablate the prostate, the proposed system for classifying the aperture could have a considerable future application.

• Authors: L S Marks, B Treiger, F J Dorey, E D Shery
• Journal: Journal of endourology (J Endourol) Vol. 9 Issue 2 Pg. 175-81 (Apr 1995) ISSN: 0892-7790 [Print] United States
• PMID: 7543329 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Aged, 80 and over
• Endoscopy
• Follow-Up Studies
• Humans
• Laser Therapy (methods)
• Male
• Middle Aged
• Prostatic Hyperplasia (physiopathology, surgery)
• Prostatic Neoplasms (physiopathology, surgery)
• Treatment Outcome
• Video Recording
• Wound Healing