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A 63-year-old male with symptomatic benign prostatic enlargement (220 ml as estimated by transrectal ultrasonography) was underwent transurethral holmium laser enucleation. Total operative time was 211 minutes and actual weight of tissue enucleated was 156 grams. There was no perioperative hyponatremia and a blood transfusion. The duration of catheterization was 3 days and the hospital stay was 5 days. Three months after treatment, the international prostate symptom score (IPSS) decreased from 19 preoperatively to 1. The quality of life (QOL) index decreased from 6 preoperatively to 1, whilst the maximum flow rate (Qmax) increased from 7 ml/sec preoperatively to 58 ml/sec.

Background and Purpose: We conducted a questionnaire survey concerning the prevalence and preference with regard to various types of surgical treatment for benign prostatic hypertrophy (BPH), in order to gather preliminary data that may be helpful for standardizing the surgical treatment of BPH., Method: A questionnaire survey was mailed to institutes in which a council member of the Japanese Endourology and ESWL Society was present. The questions dealt with the type and volume of surgical treatment experienced previously, and the treatments which had been performed in each institute during 2000. Preferences concerning cost effectiveness, safety, degree of invasion, efficacy, overall usefulness, and the possibility of prevalence from now on at general hospitals were also asked with regard to each surgical treatment., Results: Of the 155 institutes to which the questionnaire was sent, 70 responded (45% response rate). TUVP (transurethral vaporization of the prostate by thick-loop) was second to TURP (transurethral resection of the prostate) both regarding the volume of the surgical treatment that had been experienced previously, and the volume that had been performed during 2000. TURP was recognized as the most preferred treatment with regard to both cost effectiveness and overall usefulness, while TURF (transurethral radiofrequency thermotherapy) was preferred both for safety and reduced invasiveness, and open surgery for efficacy. Minimal invasive surgical treatment, such as TUVP, followed by ILCP (interstitial laser coagulation of the prostate) and TUMT (transurethral microwave thermotherapy) was recognized as the most preferable treatment for dealing with the prevalence from now on at general hospitals., Conclusion: Each minimal invasive surgical treatment was recognized as being safer and less invasive, but less effective and less useful compared to TURP. Among these surgical treatments, TUVP by thick-loop was recognized as being second choice to TURP with regard to efficacy and overall usefulness. As a matter of course, it would seem to be essential to evaluate long-term efficacy in addition to both safety and invasiveness when trying to standardize the surgical treatment for BPH.