Since 1992, we have performed the VLAP using right angle laser derivery system (Urolase) for the patients of BPH with significant underlying non-urological diseases such as cardiovascular disease, malignant disease, DM and pulmonary disease. Sufficient clinical outcome has obtained without major complication after a short term and a long term observation. In this study, we discuss the clinical advantages and safety in comparison with TUR-P through the analysis of the clinical courses of the VLAP for the patients treated with anticoagulant agents such as warfarin. In our series of 40 cases, 8 patients were treated with anticoagulant for the reason of cardiovascular disease. During the procedure and after the operation, no significant complications were encountered except for a transient postoperative bleeding.
And 8 cases with anticoagulant therapy underwent TUR-P were also analyzed as a comparison. The time of the procedure and the volume of the blood loss were significantly reduced by VLAP. The hemostatic nature of YAG laser energy seems to result in a technical improvement on conventional TUR-P for the patients under anticoagulant therapy.