The value of urodynamics in laser prostatectomy

Objective: To present the results of laser prostatectomy on urodynamic parameters, and to address the role of pressure/flow studies as diagnostic tools for optimal selection of candidates for this treatment modality. Material and Methods: The world literature, available on Medline, presenting urodynamic parameters in patients subjected to laser prostatectomy was studied. We compared the data of different series, and when it was feasible from intrinsic features of a particular study, urodynamic results were plotted on the ICS Provisional Nomogram. Results: A general shift to a less obstructive status has been documented in all series, using different methods of data interpretation. No clear differences, in terms of elimination of obstruction, could be detected among different types of laser. Plotting the data on the ICS Provisional Nomogram, most series slide from the obstructed to the unobstructed zone. The observation that clearly obstructed groups accomplish the most impressive results, further emphasizes the value of urodynamics in the initial evaluation of benign prostatic hyperplasia patients by assisting in the appropriate choice of the therapeutic modality. Conclusions: Using the objective parameters of infravesical obstruction, laser prostatectomy has proved an effective treatment of benign prostatic hyperplasia. The role of pressure/flow studies in patient selection is justified, as this investigation permits identification of those cases who are going to have a direct benefit from a desobstructive procedure. Copyright (C) 2000 S. Karger AG, Basel.