Diode Laser Treatment of Human Prostates: A Clinical 2-Year Experience

Laser-assisted vaporization of prostate tissue by means of the KTP laser is in clinical use. Alternative laser sources are available, but are lacking clinical experience. In this study, the capability, feasibility, and post-operative outcome of vaporization of prostate by means of a diode laser were investigated. The light (980 nm, 100 W) of a diode laser was fed into a side-fire fiber introduced through a 22F continuous-flow cystoscope, and thus transmitted to prostate tissue. Normal saline was used for irrigation. The study included 70 males suffering from bladder outlet obstruction due to benign prostatic hyperplasia (BPH) (prostate volume range: 61.1±16.1 cm3). The prostatic lobes were vaporized within the prostatic capsule. Depending on the vaporized tissue, the exposure time was in the range of 60.6±22.6 hours. Post-operative outcome and voiding were evaluated during a follow-up of 24 months. During surgery, no significant blood loss or any fluid absorption occurred. Catheters were removed in the 20.1±4.6 hours. All patients except two were satisfied with their voiding outcome. After removing the catheter, the mean peak urine flow rate significantly increased from 6.8±2.5 ml/s pre-operatively to 15.6±3.1 ml/s post-operatively. No evidence of urgency, dysuria, hematuria, or incontinence was observed. Four patients required re-catheterization andtow of them consecutive TURP. After a 1- month, as well as after a 6-month, a 12-mouth, and a 1-year follow-up, all patients were still satisfied with the outcome. This long term experience showed that 100 W-980 nm-diode-laser vaporization prostatectomy was feasible and appeared to be safe and effective for quickly relieving bladder outlet obstruction due to BPH.