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Objective To evaluate the incidence of urinary tract infections (UTIs) after transurethral laser therapy of the prostate and the need for peri-operative antibiotics. Patients and methods One-hundred and sixteen patients (mean age 65 years, range 51–85) with benign prostatic enlargement (BPE) were treated with a Nd:YAG laser, using either the TULIP device, the Urolase fibre or the Ultraline fibre. The incidence of voiding complaints, UTIs and the need for catheterization after treatment were assessed. The first 43 patients (Group I) received no antibiotics peri-operatively and the next 73 patients (Group II) received co-trimoxazole for 5 days. Results The patients treated using the TULIP device had more urinary complaints after treatment than those treated using the Ultraline and Urolase fibres. In Group I, 48% of the patients developed a UTI and in Group II the incidence of UTIs decreased to 30% after treatment. The incidence of UTIs was unrelated to the procedure performed. Although not statistically significant, peri-operative antibiotics tended to reduce the incidence of UTIs. Prolonged catheterization was correlated with the incidence of UTI. In Group I, patients who were treated using the Ultraline procedure had their catheter removed after a mean of 24 days, compared with 21 days for those treated with the Urolase and 19 days with the TULIP device. In Group II, the patients needed catheterization for a mean of 17 days following Ultraline treatment and 16 days following the Urolase procedure. Conclusions Antibiotic prophylaxis tended to decrease the incidence of post-treatment UTIs. However, there was no clear association between the presentation and duration of complaints and the presence of UTIs.

Objective To determine if bladder outlet obstruction can be adequately relieved after laser prostatectomy. Patients and methods Since November 1992, a total of 105 patients underwent laser treatment of the prostate because of complaints related to benign prostatic enlargement (BPE). To date, urodynamic data from a study of pressure flow analysis are available for 79 patients both at baseline and at 6 months after treatment. Patients were evaluated using changes in symptoms (IPSS symptom score), peak flow rate (Qmax), post-voiding residual volume (PVR), detrusor pressure at maximum flow (Pdst at Qmax), and the linear passive urethral resistance relation (LPURR). Moreover, patients with minimal bladder outlet obstruction were compared to patients with severe bladder outlet obstruction. Results There was a significant improvement in mean IPSS score from 21.3 at baseline to 5.3 at the 6-month follow-up. The Qmax improved from 7.9 mL/s to 17.8 mL/s, and the PVR decreased from 91.6 mL to 15.6 mL. At baseline, > 80% of the patients were considered obstructed according to the analysis of pressure flow, whereas 6 months after laser treatment, only 5% of the patients were still considered obstructed. A comparison of the outcome between minimally obstructed patients and severely obstructed patients showed comparable improvements. Conclusion Laser therapy of the prostate was, according to urodynamic parameters, capable of relieving outlet obstruction and minimally obstructed patients also showed a significant relief of outlet obstruction.