Laser Surgery of the Bladder Neck and Prostate

Sixty patients with proven urologic outlet obstruction were studied. Each patient had cystometric studies, cystoscopy and uroflometry. A total of forty-one males underwent photoirradiation of the bladder neck while 19 patients underwent treatment for prostatic adenoma; some in combination with bladder neck contractures. All patients were screened with transrectal ultrasonography of the prostate and were eliminated from the study with any suggestion of abnormality. Procedures were accomplished using a 100 watt Neodymium;YAG laser with type of delivery source varying from contact probes at low energy to bare fibre in direct contact at watts ranging from 60–80 watts. The procedure that seemed most effective was bare fibre, high energy contact therapy. Patients were followed up from 3–30 months and though early in the observation period, some conclusions appear clear from our results. Patients underwent all procedures under local anesthesia or intravenous sedation with Diazepam or occasional Demerol in the office setting as outpatients. Patient’s ages ranged from 49–88 years. Results can be divided into two groups: laser therapy of the bladder neck for contracture and laser prostatotomy.