The diode laser: a novel side-firing approach for laser vaporisation of the human prostate--immediate efficacy and 1-year follow-up.
OBJECTIVE
A prototype diode laser was used to evaluate the feasibility and postoperative outcome of diode laser vaporisation of the prostate in patients with bladder outlet obstruction (BOO) necessitating interventional desobstruction.


METHODS
Ten patients were included in this pilot study. The prostate was vaporised via a side-fire laser fibre (diode laser at 1470 nm, 50 W; Biolitec-AG, Jena, Germany). IPSS, quality of life, Q(max), and PVR volume were measured pre- and postoperatively and 1 yr after the intervention.


RESULTS
Prostate volumes were 35-78 ml. A mean 121 kJ (61-200 kJ) of energy was delivered. No patient had significant blood loss or fluid absorption. Three-way catheters were removed after a median of 33 h. Q(max) increased from 8.9 ml/s (3.6-13.2 ml/s) preoperatively to 15.7 ml/s (10.5-22 ml/s) (p<0.01) postoperatively. After the 12-mo follow-up, Q(max) increased to 22.35 ml/s (+/-4.32 ml/s; p<0.001). PVR volume changed from a baseline of 243 ml to 26.9 ml (p<0.001) after 12 mo. Volume reduction was estimated by transrectal ultrasound postoperatively (15 cc+/-6.39), and by PSA levels before surgery (3.8 ng/ml+/-2.3) and after 6 mo (2.64 ng/ml+/-1.51). No patient is incontinent. Two patients required recatheterisation postoperatively on days 1 and 2, respectively. Two patients required TURP within 2 mo. All patients without reintervention have presented for the 1-yr follow-up examination and are satisfied with the outcome.


CONCLUSIONS
Our preliminary findings indicate that 50-W diode laser vaporisation prostatectomy at 1470 nm is feasible and appears to be effective for acutely relieving BOO.
Seitz
Michael
M
Department of Urology, University Hospital Grosshadern, Ludwig-Maximilians-University Munich, Germany. Michael.Seitz@med.uni-muenchen.de
Sroka
Ronald
R
Gratzke
Christian
C
Schlenker
Boris
B
Steinbrecher
Verena
V
Khoder
Wael
W
Tilki
Derya
D
Bachmann
Alexander
A
Stief
Christian
C
Reich
Oliver
O
D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000150:complications / Q000628:therapy*; D001748:Urinary Bladder Neck Obstruction / Q000628:therapy*; D014835:Volatilization