Treatment of benign prostatic hyperplasia by transurethral ultrasound- guided laser-induced prostatectomy (TULIP): Effects on urodynamic parameters and symptoms

Objectives This prospective study was undertaken to evaluate the effects oftransurethral ultrasound-guided laser-induced prostatectomy (TULIP) on urodynamic, symptomatic, and prostate volume parameters as well as serum prostate-specific antigen. Methods The TULIP procedure was performed in 33 patients with benign prostatic hyperplasia with a mean age of 66 years. Patients were evaluated by pressure—flow studies, prostate volume measurement by transrectal ultrasound, and the American Urological Association (AUA) symptom score. Results At 3-month follow-up, laser prostatectomy has resulted in an increased maximum flow rate from 6.6±0.5 to 11.2±0.6 mL/s and in an objectively proven relief of the urodynamic obstruction, as is evident by a decrease of the average value of the urethral resistance parameter URA and the detrusor pressure at maximum flow rate from 38.3 ± 2.7 to 21.3 ± 1.3 cm water and from 62.7 ±4 to 38.9 ± 2.1 cm water, respectively. Symptomatic improvement is evident from a decrease in the AUA symptom score from 20.4 at baseline to 8.8 at 6-month follow-up. Although the total symptom score did not change significantly between 6 months and 1 year follow-up, the score of the symptom “weak stream” was significantly higher again at 12 months follow-up. Conclusions The TULIP procedure is a urodynamically and symptomatically effectivetreatment. Conclusions about the durability of this treatment modality should be made with reservations.

• View at Publisher
• View at Pubmed
• View at Scopus

Free Full Text ( Final Version , 830kb )