title: Penetration depth with the XPS GreenLight laser assessed by contrast enhanced ultrasonography.
abstract: OBJECTIVE
  The GreenLight laser is one of the main alternative treatments for benign prostatic hyperplasia (BPH). Ultrasonography with contrast (ECUS) is one of the main innovations in radiology that has led to the examination of tissue vascularity. The objective of the study was to measure the impact of photovaporization of the prostate (PVP) on the prostate gland with ECUS.
  
  
  METHODS
  We conducted a pilot study to assess the impact of PVP on the prostate by using ECUS intraoperatively (ethical committee approval No. 2012-001451-39). Twelve patients undergoing PVP for symptomatic BPH were enrolled in this study after providing their informed consent. ECUS was performed just before and after PVP in the operating room and at 1 month postoperatively.
  
  
  RESULTS
  Comparative analysis showed that after PVP, a nonvascularized area with an average thickness of 11.1 mm was observed beyond the operative cavity. The nonvascularized area was thinner at 1 month postoperatively and disappeared at 6 months for the six patients evaluated. This is the first study using contrast-enhanced ultrasonography to measure the impact of PVP on the prostate. Our study has the limitations of a pilot study with a small population and a short follow-up. Based on these results, we would advise beginners to take into account the necrosis thickness and to limit the depth of vaporization.
  
  
  CONCLUSIONS
  Through the use of ECUS, our study demonstrated that a large area of necrosis is induced around the surgical cavity from the action of the GreenLight laser. Being aware of this phenomenon will certainly reduce the risk of complications induced by surgery.
authors.affiliation: 1 Urology Department , CHU de Tours, Tours, Loire Valley, France .
authors.forename: Franck
authors.initials: F
authors.lastname: Bruyère
authors.forename: Thomas
authors.initials: T
authors.lastname: Bodin
authors.forename: Aurore
authors.initials: A
authors.lastname: Bleuzen
authors.forename: Fredèric
authors.initials: F
authors.lastname: Patat
authors.forename: Laurent
authors.initials: L
authors.lastname: Brunereau
mesh_terms: D000368:Aged; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation* / Q000379:methods; D007834:Lasers; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011468:Prostatectomy / Q000295:instrumentation* / Q000379:methods; D011470:Prostatic Hyperplasia / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000295:instrumentation* / Q000379:methods