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 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.