Contact laser Vaporization of the Prostate (CVP) is a surgical treatment option for benign prostatic hyperplasia (BPH). CVP is the instant evaporation of swollen prostate tissue that is accomplished by irradiating the prostate tissue with a laser beam (e.g., a 980 nm diode laser) through an optical fiber. In Japan, regulatory approval was obtained in April 2016, and the Kochi University Hospital was the first public university hospital in Japan to introduce this procedure in March 2023. In general, the effectiveness of treatment in benign prostatic hyperplasia surgery is often evaluated based on subjective symptoms; however, in this study, we also evaluated other findings using the pressure flow study (PFS).

Between March 31, 2023, and March 1, 2025, 82 patients underwent CVP at our institution. Among them, 31 patients with PFS findings both before and 3 months after surgery were analyzed for treatment outcomes using the Overactive Bladder Symptom Score (OABSS), International Prostate Symptom Score (IPSS), Quality of Life (QOL) scores, and PFS parameters. Perioperative complications were assessed in 82 patients.

The mean patient age was 75.9 years, with an average prostate volume of 64.9 mL and post-void residual volume of 150mL. The mean bladder outlet obstruction (BOO) on the Schafer nomogram was 3.9. The mean total OABSS and score were 7.2, and the mean total IPSS score was 16.7. CVP using the XCAVATOR fiber was performed in 8 patients.Surgical outcomes were as follows: the mean operation time was 91.3 minutes, laser irradiation time was 48.7 minutes, catheterization duration was 3.1 days, and the mean hospital stay was 4.8 days. Significant improvements in the IPSS and QOL scores were observed one month postoperatively. Three months postoperatively, PFS showed significant improvements in the bladder outlet obstruction index (BOOI) (Fig. 1), PdetQmax, Qmax, voided volume, and post-void residual volume. However, no significant changes were observed in the bladder contractility index (BCI), first desire to void (FDV), normal desire to void (NDV), or maximum cystometric capacity (MCC).Perioperative complications included transient urinary retention in eight patients (9.7%), urinary tract infection in eight patients (9.7%), postoperative bleeding in four patients (4.8%), and urinary incontinence in one patient (1.2%).

Our study demonstrated that CVP effectively improved lower urinary tract symptoms and bladder outlet obstruction. The PFS evaluation confirmed significant improvements in bladder outlet obstruction parameters. Further studies are warranted to assess long-term outcomes and their impact on bladder function.