Nonablative transurethral Erbium:YAG laser treatment for chronic prostatitis/chronic pelvic pain syndrome: A prospective comparative study

Adrián Gaspar, Joaquín Silva, Gustavo Silva, Raúl Anchelerguez, Jorge Prats, Alejandro Sagaz, Eduardo Rovere, Mauricio Alastra, Juan Pino, Alejandro Jauregui, Marcos Farrugia, Fabricio Villaroel, Jonathan Guareschi, Maximiliano Vega, Emanuel Biasiori, Emanuel Moyano, Antonio La Rosa, Irena Hreljac, Zdenko Vižintin, Adrián Gaspar, Joaquín Silva, Gustavo Silva, Raúl Anchelerguez, Jorge Prats, Alejandro Sagaz, Eduardo Rovere, Mauricio Alastra, Juan Pino, Alejandro Jauregui, Marcos Farrugia, Fabricio Villaroel, Jonathan Guareschi, Maximiliano Vega, Emanuel Biasiori, Emanuel Moyano, Antonio La Rosa, Irena Hreljac, Zdenko Vižintin

Abstract

Aims: This prospective study aimed to compare the clinical outcomes between the use of Erbium:YAG (Er:YAG) laser in a nonablative mode, to the use of the pharmacological treatment of oral tadalafil for the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).

Methods: The laser group received two sessions of Erbium:YAG laser, administered intraurethrally in a long, nonablative train of long pulses (SMOOTH™ mode), applied at the level of the male prostatic urethra. Tadalafil group received oral tadalafil at a dose of 5 mg/day, consecutively for 2 months. Effectiveness was assessed using the International Prostate Symptom Score (IPSS) questionnaire, VAS (visual analogue scale) pain score, and maximum urethral flow at follow-up visits up to 12 months after initiating treatment. Adverse effects were recorded after each treatment and follow-up sessions.

Results: The results show a significant decrease in the IPSS score in both groups up to the 12-month follow-up. The increase in Q-max was evident up to 3-months follow-up in the tadalafil group and up to 6 months in the laser group. The decrease in the VAS pain score was also significant in both treatment groups, lasting up to 3 months in the tadalafil group and up to 6 months in the laser group.

Conclusions: The nonablative Er:YAG SMOOTH™ laser seems to be a promising treatment for this widely occurring condition. More studies are needed to confirm its safety and efficacy.

Keywords: chronic prostatitis with chronic pelvic pain syndrome; nonablative Er:YAG laser therapy; tadalafil.

Conflict of interest statement

Irena Hreljac and Zdenko Vižintin are currently employed at Fotona d.o.o.

© 2020 The Authors. Neurourology and Urodynamics Published by Wiley Periodicals LLC.

Figures

Figure 1
Figure 1
(A) International Prostate Symptom Scores (IPSS) of the laser group. The graph shows the proportions of laser group patients (N = 16) in each IPSS severity category at baseline and at follow‐ups. (B) IPSS of the tadalafil group. The graph shows the proportions of tadalafil group patients (N = 20) in each IPSS severity category at baseline and at follow‐ups
Figure 2
Figure 2
Decrease in International Prostate Symptom Scores (IPSS). The graph shows the mean decrease (±SEM) of IPSS scores in both groups (laser group, N = 16; tadalafil group, N = 20) at each follow‐up session in relation to the baseline IPSS score
Figure 3
Figure 3
(A) The graph shows mean (±SEM) VAS (visual analogue scale) pain scores at baseline and follow‐ups in both groups (laser group, N = 16; tadalafil group, N = 20). (B) The graph shows mean (±SEM) VAS dysuria scores at baseline and follow‐ups in both groups (laser group, N = 16; tadalafil group, N = 20); *p < .05 statistical significance from the baseline value

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