The Asia-Pacific Guidelines for ‘Índigo’ interstitial laser coagulation in the management of benign prostatic hyperplasia

Abstract

A panel of urologists experienced in interstitial laser coagulation (ILC) gathered to formulate practice guidelines for ILC. The aim was to avoid abuse or inappropriate applications leading to problems that may jeopardise the welfare of patients, and to formulate a common rationale for treatment to facilitate reimbursement for benign prostatic hyperplasia (BPH) treatment in Asia-Pacific countries and elsewhere. The authors reviewed data from the literature and accumulated experience from over 1000 patients who have undergone ILC since 1991. ILC for BPH treatment is a safe procedure with a low complication profile and its effectiveness is comparable to that of transurethral resection of the prostate (TURP). Temporary voiding irritation for 2–4 weeks and a catheterisation period of 5–7 days are the major disadvantages seen in those who had eight punctures or more for their BPH. Despite the seemingly higher direct cost arising from investment in laser unit and fibre-optic equipment, other benefits of ILC — such as short hospitalisation, early return to work, treatment safety and low complication profile — outweigh this initial outlay and make ILC an economical treatment option. ILC is an easy-to-learn, safe and effective procedure for BPH treatment. The low morbidity profile makes ILC a valuable option for BPH patients who have serious underlying disease, or who are poor surgical risks for TURP or other invasive modalities.