Combined endoscopic laser ablation of the prostate (ELAP) and temporary prostatic stenting

Summary

Delayed relief of bladder outflow obstruction has limited the use of laser ablation of the prostate (ELAP). This clinical study was to evaluate the combination of temporary prostatic stenting (a new one size stent) with ELAP in 25 consecutive patients with outflow obstruction, including cases of urinary retention, which might accelerate the time to symptomatic benefit or relief of symptoms. Flow rate, residual volume and symptom score were repeated at 6 weeks. The stent was removed under local anaesthetic at 3 months. Twenty-two of 25 voided immediately post-operatively, including 4 of 5 with previous urinary retention. Early stent migration occurred in one case. Late symptomatic migration was not seen. Mean Q_max improved from 8ml/s to 16.5ml/s at 6 weeks. Voiding scores and residual volumes fell. Previously reported ‘prostatitis’ symptoms were not identified. The use of temporary prostatic stenting enables catheter-free ELAP with early improvement of flow and reduction of voiding score.

Key Words:

• prostatic stent
• ELAP
• bladder outflow obstruction
• laser