Short-term report on transurethral diode laser vaporization of the prostate at Ahmadu Bello University Teaching Hospital, Zaria-Nigeria

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Background: Laser vaporization of the prostate is an evolving addition to the armamentarium for prostate surgery. This is despite the availability of cheaper treatment modalities such as open prostatectomy and transurethral resection of the prostate (TURP). However, diode laser vaporization in this regard has the advantages of a shorter learning curve and minimal complications. This paper was aimed at assessing the effectiveness of this mode of therapy and to share our initial experience with this procedure. Patients and Methods: This was a prospective study carried out over a period of 18 months. All men requiring surgery for bothersome prostatic obstruction with benign prostate size ≤100 g were included. Those with malignant prostatic obstruction irrespective of size were also included. The exclusion criteria were benign prostate of size >100 g, and indication for open prostatectomy/channelization or medical therapy. Clearance was obtained from the Health Research Ethics Committee of the institution and informed consent was obtained from all the patients. Each patient's demographics and pre-, intra-, and post-operative details were entered into a pro forma. Results were analyzed using descriptive statistics. Results: Eleven men were included in this study, aged 59-81 years with a mean of 67 years. 63.6% had benign prostatic hyperplasia (BPH) while the remaining 36.4% had carcinoma of the prostate. The mean prostate size was 88 g with a range of 54-182 g. Main symptoms were severe or bothersome lower urinary tract symptoms (LUTS). The mean operating time (lasing time) was 65 min. There were no intraoperative complications and none required blood transfusion. Most had irrigation for only 24 h, one didn't require irrigation while two others required irrigation for 48 h and 72 h, respectively. Out of all the patients, 90.9% had catheter removed at ≤48 h, while one had catheter removed on the fifth postoperative day. All except one were discharged at 72 h or less postoperatively. All the patients had satisfactory subjective outcome at a mean follow-up of 9 months with a range of 1 to 18 months. Conclusion: We found transurethral laser vaporization of the prostate to be effective and safe in the treatment of prostatic obstruction. However, a study involving larger number of patients and longer follow-up will establish its true place in the management of prostatic obstruction in our environment.