NON-ABLATIVE ERBIUM YAG LASER TREATMENT FOR CHRONIC PROSTATITIS/CHRONIC PELVIC PAIN SYNDROME

To assess the efficacy and safety of transrectal non-ablative Erbium YAG laser for treatment of Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS).

Patients with diagnosed CP/CPPS were treated with non-ablative Erbium YAG laser. Three laser sessions were executed with intervals of one and three months followed by one maintenance session when effect started to fade. The assessment of efficacy was done with ultrasound (US) measurement of the prostate volume and US assessment of the prostate vascularization through the count of visible blood vessels (VBV) and of the total vascular image which also included the vessels size. The volume and vascularization were assessed at each of four visits, before the laser treatment and 15 minutes after the laser treatment. Two weeks after each treatment session patients were checked for CP/CPPS symptoms changes and possible adverse effects.

51 male patients with average age of 37.4 years received four laser treatments. Laser energy was delivered transrectally to the prostate. Laser parameters used were: Smooth, 7 mm spot, 3 J/cm2, 1.6 Hz, 7 stacks. Prostate volumes showed reduction immediately after the treatment at each of the sessions and these reductions were well maintained through all successive follow-ups. VBV were counted before and after each session and showed significant increases throughout the whole observation period. At the beginning of the therapy the overall prostate vascularization was assessed as poor in 35.3% patients, as fair in 21.6%, as good in 39.2% and as very good in 3.9% patients. Improvements during the treatments and follow-ups were: FU1: 7.8% poor, 15.7% fair, 37.3% good and 39.2% very good; FU2: 0% poor, 6.3% fair, 27.1% good and 66.7% very good; FU3: 5.6% poor, 8.3 % fair, 33.3% good and 52.8% very good. There were no adverse effects after this therapy and patients’ satisfaction with the improvements was high.

Non-ablative Erbium YAG laser treatment seems to be promising new non-invasive and safe therapy for CP/CPPS showing improvement of the symptoms lasting at least one year. More studies are needed to additionally prove its efficacy and safety.

No conflicts.