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Interstitial laser coagulation for management of benign prostatic hyperplasia: Long‐term follow‐up
Author(s) -
TERADA NAOKI,
ARAI YOICHI,
OKUBO KAZUTOSHI,
ICHIOKA KENTARO,
MATSUI YOSHIYUKI,
YOSHIMURA KOJI,
TERAI AKITO
Publication year - 2004
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2004.00944.x
Subject(s) - medicine , prostate , quality of life (healthcare) , transurethral resection of the prostate , hyperplasia , medical record , surgery , international prostate symptom score , laser coagulation , urology , lower urinary tract symptoms , nursing , cancer , visual acuity
Aim: We evaluated the long‐term results of transurethral interstitial laser coagulation in the treatment of benign prostatic hyperplasia (BPH) with up to 9 years of follow up at the Kurashiki Central Hospital and determined the patient characteristics that predict a favorable outcome. Methods: From December 1993 to May 1997, a total of 82 patients were enrolled in the present study. Subjective and objective voiding parameters were collected from medical records and a self‐administered questionnaire was sent to the patients. Kaplan‐Meier plots were constructed to assess the risk of retreatment. Results: The mean follow‐up period was 48.4 months (range, 3–108 months). A total of 59 patients (72%) did not need any additional treatment at 12 months and 30 patients (37%) did not require additional treatment during the entire follow‐up period. A total of 29 patients (35%) were retreated during follow‐up. Transurethral prostate resection (TURP) was performed in 18 patients (22%). The remaining 11 patients (13%) were offered additional pharmacotherapy. The minimum and median retreatment‐free durations were 3 and 14 months, respectively. Seven patients died and 17 were lost to follow‐up. Men aged 71 years or older had greater likelihood of requiring retreatment than those younger than 71 years ( P = 0.0397). No significant differences were noted in the other baseline characteristics. Among postoperative parameters, a rate of decrease of the International Prostate Symptom Score of the patient of lower than 60% and a rate of decrease in patient quality of life of lower than 50% at 3 months were associated with greater likelihood of retreatment ( P = 0.0083 and P = 0.0006, respectively). Conclusions: Interstitial laser coagulation is effective for the treatment of BPH. Good long‐term results and an acceptably low retreatment rate render this modality an effective alternative to TURP, especially for younger patients. Short‐term improvement of subjective symptoms was predictive of favorable long‐term outcome.