Treatment of benign prostatic hyperplasia by transurethral ultrasound-guided laser-induced prostatectomy (TULIP): effects on urodynamic parameters and symptoms.
OBJECTIVE
This prospective study was undertaken to evaluate the effects of transurethral 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 effective treatment. Conclusions about the durability of this treatment modality should be made with reservations.
Bosch
J L
JL
Department of Urology, Erasmus University and Academic Hospital, Rotterdam, The Netherlands.
Groen
J
J
Schröder
F H
FH
D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery; D011312:Pressure; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012086:Reoperation; D012212:Rheology / Q000379:methods; D014463:Ultrasonography; D014556:Urine; D014563:Urodynamics
D017430:Prostate-Specific Antigen