High-energy visual laser ablation of the prostate in men with urinary retention: Pressure-flow analysis

Abstract

Objectives. To assess the efficacy of high-energy visual laser ablation of the prostate (VLAP) in men withurinary retention, using subjective and objective data. Methods. Seventeen men in urinary retention underwent high-energy VLAP. The mean patient age was 69years, and the mean follow-up was 12 months. All men were urodynamically obstructed by pressure-flow analysis with a functioning detrusor muscle. Interviews assessed retrograde ejaculation and patient satisfaction. Results. The mean total energy applied was 71,088 J (range 27,556 to 110,294). The mean peak noninvasive urine flow rates increased from 2.1 to 18.1 cc/s, and the mean postvoid residual volumes decreased from 550.0 to 39.0 cc. The mean detrusor pressure at peak flow decreased from 66.4 to 41.9 cm H 2O, and the mean maximal detrusor pressure decreased from 72.2 to 49.2 cm H 2O. Ten men (59%) voided to completion within 1 week post-VLAP. The mean postoperative International Prostate Symptom Score was 6. Nine men (53%) reported new retrograde ejaculation, and 14 men (82%) were satisfied with their outcome. Conclusions. High-energy VLAP is an effective procedure for relief of bladder-outlet obstruction in men with urinary retention.