Nd:YAG laser incision of the vesical neck in obstructive BPH

Peter T. O. Gilbert

doi:10.1117/12.476380

12 September 2003 Nd:YAG laser incision of the vesical neck in obstructive BPH

Peter T. O. Gilbert

Proceedings Volume 4949, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems XIII; (2003) https://doi.org/10.1117/12.476380
Event: Biomedical Optics, 2003, San Jose, CA, United States

Abstract

From February, 1995 through June, 2002, 68 patients underwent laser incision of the prostate at our clinic. By means of a 23 F cytoscope and a 600 micrometer lateral firing quartz fiber the vesical neck was incised at the 5 and 7 o'clock position at 60 W power. Total energy averaged 13648 J. Operative time did not exceed 15 minutes. General anesthesia was employed in all but one patient. 38 patients remained catheter-free whereas 30 patients were catheterized for two hours. Except for three cases, all patients were discharged on the same day, usually after the first micturition. Anti-inflammatory treatment was administered for two weeks, Cotrimoxazole for 5 days. No serious complications were encountered. Minor side effects included urinary retention (1 pat.), urinary infection (3 pat.) and retrograde ejaculation (1 pat.). Considering a mean follow-up of 21 months, the average Qmax improved enormously (25.4 ml/s versus 10.9 ml/s), as did residual urine volume (35 ml versus 95 ml) and IPSS (7.1 versus 20.5). Three patients required TUR-P 2-3 years after laser surgery and one patient underwent radical retropubic prostatectomy for prostate cancer 2 years later. In conclusion, Nd:YAG laser incision of the prostate is a simple, safe, reliable and cost-effective outpatient procedure.

Citation Download Citation

Peter T. O. Gilbert "Nd:YAG laser incision of the vesical neck in obstructive BPH", Proc. SPIE 4949, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems XIII, (12 September 2003); https://doi.org/10.1117/12.476380

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