Endoscopic laser ablation of the prostate. A new technique for treating prostate problems.

Bladder outflow obstruction due to benign prostatic enlargement affects up to a third of men over the age of 50. To date, the only reliable form of treatment is surgical, mainly by transurethral resection of the prostate (TURP). An alternative technique, endoscopic laser ablation of the prostate (ELAP) has recently been introduced to overcome some of the drawbacks of TURP. ELAP involves directing laser energy via a specially designed side-firing fibre at the enlarged portion of the prostate. The fibre, passed into the prostate through a cystoscope, carries the energy from the laser to the prostate causing heating of the prostate and subsequent shrinkage of the gland. The operation is performed under general or spinal anaesthetic and is quicker to perform than a TURP. Because the laser causes virtually no bleeding, patients can be treated as day cases or go home the day after surgery. A catheter is left in the bladder and is removed as an out-patient a few days later. The early results of ELAP are comparable to TURP, but complications and length of hospital stay are less.