Tissue effects resulting from eraser laser enucleation of the prostate: in vivo investigation

• Published in: Urologia internationalis Vol. 91; no. 4; p. 391
• Main Authors: Lusuardi, L, Hager, M, Kloss, B, Hruby, S, Colleselli, D, Zimmermann, R, Janetschek, G, Mitterberger, M
• Format: Journal Article
• Language: English
• Published: Switzerland 01.01.2013
• Subjects: Aged; Biopsy; Blood Coagulation; Follow-Up Studies; Hemostasis; Humans; Laser Therapy - instrumentation; Laser Therapy - methods; Lasers; Male; Middle Aged; Prostate - surgery; Prostatic Hyperplasia - surgery; Quality of Life; Severity of Illness Index; Treatment Outcome; Urinary Bladder Neck Obstruction - etiology; Urinary Bladder Neck Obstruction - psychology; Urinary Bladder Neck Obstruction - surgery
• ISSN: 1423-0399
• DOI: 10.1159/000353554

BACKGROUND/AIMS/OBJECTIVES: To describe the depth of the laser coagulation zone in vivo based on histological examinations and the functional outcome of a 1,318-nm diode laser for enucleation in benign prostatic enlargement (BPE). A total of 20 patients with BPE were treated by laser Eraser® enucleation of the prostate (ELEP). Prostatic tissue wedges were evaluated to assess the depth of the ELEP coagulation zones. Additionally, patients were assessed preoperatively and 12 months postoperatively. The coagulation zones were 0.36 ± 0.17 mm in epithelial tissue, 0.28 ± 0.15 mm in stromal tissue, and 0.25 ± 0.12 mm in mixed tissue. The coagulation area at the cutting edge completely sealed capillary vessels, reaching a depth of 0.35 ± 0.15 mm. The diameter of the coagulated vessels measured 1.75 ± 0.83 mm. Mean blood loss was 115.54 ± 93.12 ml, catheter time 1.35 ± 0.33 days, and hospital stay 1.89 ± 0.52 days. The International Prostate Symptom Score, maximal flow rate, and quality of life significantly improved 12 months after the procedure. ELEP is safe and effective for BPE treatment and yields good results at a follow-up of 1 year. Because of the limited penetration depth, damage to the urinary sphincter is not expected.