(207) NON-ABLATIVE ERBIUM YAG LASER TREATMENT FOR CHRONIC PROSTATITIS/CHRONIC PELVIC PAIN SYNDROME
Authors: Kotb H , Vizintin Z 
Published: December 2024

Introduction

Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is quite common problem in men for which there is still a need for good, non-invasive but efficacious therapeutic methods. In this study we were investigating the use of laser for CP/CPPS.

Objective

To assess the efficacy and safety of transrectal non-ablative Erbium YAG laser for treatment of CP/CPPS.

Methods

This is a retrospective cohort study executed in one medical center in period from 2018 till 2023. Patients with diagnosed CP/CPPS were treated with non-ablative Erbium YAG laser. Three laser sessions (L1, L2, L3) were executed with intervals of one and three months followed by one maintenance session (L4) when effect started to fade (12-18 months after L3). The assessment of efficacy was done through the ultrasound (US) measurement of the prostate volume and US observation of the prostate vascularization. Assessment of vascularization was done with the count of visible blood vessels (VBV) and the observation of the total vascular image, considering not only the number but also the vessels size. The volume and vascularization were assessed at each of four visits (L1-L4), before the laser treatment and approx.. 15 minutes after the laser treatment. Two weeks after each treatment session patients were checked for CP/CPPS symptoms changes and possible adverse effects.

Results

51 male patients with average age of 37.4 years (range 22-60) received four transrectal non-ablative Erbium YAG laser treatments. Laser energy was delivered to the multiple locations of the prostate via R11 probe with angular adapter. 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. Volumes at L1 before and after the treatment were 19.5 ± 6.4 and 18.5 ± 5.9 cc, at L2 18.3 ± 6.0 and 17.2 ± 6.0 cc, at L3 18.2 ± 5.4 and 15.5 ± 4.9 cc and at L4 18.5 ± 7.0 and 14.9 ± 6.1 cc. VBV were counted before and after each session and showed increases as follow: L1: before 15.6 ± 4.5 and 19.6 ± 5.9 after, at L2 19.5 ± 4.7 and 24.2 ± 5.3, at L3 21.5 ± 4.3 and 26.7 ± 4.4 and at L4 20.9 ± 4,4 and 26.4 ± 4.1. At the beginning of the therapy (L1) 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: L2: 7.8% poor, 15.7% fair, 37.3% good and 39.2% very good; L3: 0% poor, 6.3% fair, 27.1% good and 66.7% very good; L4: 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.

Conclusions

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

Disclosure

No.