Interstitial laser coagulation for management of benign prostatic hyperplasia: long-term follow-up.
OBJECTIVE
We evaluated the long-term results of transurethral interstitial laser coagulation in the treatment of benign prostatic hyperplasia (BPH) with up to 9 years of follow up at the Kurashiki Central Hospital and determined the patient characteristics that predict a favorable outcome.


METHODS
From December 1993 to May 1997, a total of 82 patients were enrolled in the present study. Subjective and objective voiding parameters were collected from medical records and a self-administered questionnaire was sent to the patients. Kaplan-Meier plots were constructed to assess the risk of retreatment.


RESULTS
The mean follow-up period was 48.4 months (range, 3-108 months). A total of 59 patients (72%) did not need any additional treatment at 12 months and 30 patients (37%) did not require additional treatment during the entire follow-up period. A total of 29 patients (35%) were retreated during follow-up. Transurethral prostate resection (TURP) was performed in 18 patients (22%). The remaining 11 patients (13%) were offered additional pharmacotherapy. The minimum and median retreatment-free durations were 3 and 14 months, respectively. Seven patients died and 17 were lost to follow-up. Men aged 71 years or older had greater likelihood of requiring retreatment than those younger than 71 years (P = 0.0397). No significant differences were noted in the other baseline characteristics. Among postoperative parameters, a rate of decrease of the International Prostate Symptom Score of the patient of lower than 60% and a rate of decrease in patient quality of life of lower than 50% at 3 months were associated with greater likelihood of retreatment (P = 0.0083 and P = 0.0006, respectively).


CONCLUSIONS
Interstitial laser coagulation is effective for the treatment of BPH. Good long-term results and an acceptably low retreatment rate render this modality an effective alternative to TURP, especially for younger patients. Short-term improvement of subjective symptoms was predictive of favorable long-term outcome.
Terada
Naoki
N
Department of Urology, Kurashiki Central Hospital, Kurashiki, Japan.
Arai
Yoichi
Y
Okubo
Kazutoshi
K
Ichioka
Kentaro
K
Matsui
Yoshiyuki
Y
Yoshimura
Koji
K
Terai
Akito
A
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D017075:Laser Coagulation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011470:Prostatic Hyperplasia / Q000150:complications / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D011788:Quality of Life; D012086:Reoperation / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D020728:Transurethral Resection of Prostate / Q000706:statistics & numerical data; D016055:Urinary Retention / Q000209:etiology