To present the surgical technique of 1470 nm diode laser antegrade enucleation of the prostate for benign prostatic hyperplasia (BPH) and evaluate its clinical efficacy.

30 consecutive patients with BPH who underwent transurethral 1470 nm diode laser antegradeenucleation of the prostate at our institution from September 2016 to January 2017 were reviewed. The mean age of the patients was (72±9) years (range 53 to 86 years), and the prostate volume was (54±25) ml (range 27 to 120 ml). All procedures had been accomplished with antegrade approach: Firstly, two grooves deep into the capsule were created from bladder neck to 1 cm proximalto verumontanum at 5 and 7 o’clock direction. After the median lobe was vaporized, the distal margin of prostate was deepened to the capsule plane and extended to 9 and 3 o’clock position. Then the adenoma at 12 o’clock were vaporized to expose the capsule from the bladder neck to the proximal urethral sphincter. Subsequently, two lateral lobes were enucleated along the capsule with antegrade approach, respectively. The adenoma >80 ml were sucked by tissue morcellator and the adenoma <80 ml were vaporized segmentally.

The mean operation time was (65±14) min, and the median estimated blood loss [M(QR) ] was 10 (15) ml. The median postoperative hospital stay and mean duration of catheterization were 4 (3.8) d and (4.5±1.5) d (range 2 to 8 d), respectively. Preoperative and postoperative mean hemoglobin and serum sodium concentration were (129±23) versus (125±20) g/L and (141±3) versus (140±3) mmol/L, respectively, where the differences were not statistically significant. The mean IPSS score, QOL sore and Qmaxpreoperative and 1 month postoperative were (22±6) versus (8±3), (5.2±0.7) versus (1.9±0.9), and (7.8±2.1) versus (17.2±3.9) ml/s, respectively, with significantly differences. No patient experienced postoperative complications such as incontinence or urethral stricture during a median follow-up of 2.3(2.8) months (range 1 to 4 months).

Transurethral 1470 nm diode laser antegradeenucleation of the prostate is safe and effective for treatment of BPH which could provide rapid postoperative rehabilitation.