Initial Experiences with a 980 nm Diode Laser for Photoselective Vaporization of the Prostate for the Treatment of Benign Prostatic Hyperplasia

Abstract

PurposeThis study was conducted to analyze the efficacy of photoselective vaporization of the prostate (PVP) with the use of a 980 nm diode laser for benign prostatic hyperplasia (BPH) according to postoperative period.Materials and MethodsData were collected from 96 patients who were diagnosed with BPH and who underwent PVP with the 980 nm K2 diode laser. Postoperative parameters, including International Prostate Symptom Score (IPSS), quality of life (QoL) score, maximum urinary flow rate (Qmax), and post-void residual volume (PVR), were assessed and compared with preoperative baseline values.ResultsThe mean prostate volume was 45.3±15.6 g, the mean operative time (lasing time) was 22.9±18.3 minutes, the total amount of energy was 126±84 kJ, and the Foley catheter maintenance period after PVP was 24.8±5.6 hours. At 1 month, significant improvements were noted in IPSS (11.7±6.6), QoL score (2.3±1.1), Qmax (12.7±6.1 ml/sec), and PVR (41.9±30.5 ml). After 3 months, all follow-up parameters showed significant improvements that were sustained throughout a period of 6 months after PVP.ConclusionsPVP using a K2 diode laser is a minimally invasive and effective surgical method for improvement of BPH and is associated with minimal morbidity.

Outcome of 980 nm diode laser vaporization for benign prostatic hyperplasia: A prospective study

“…Although above evidence is highly suggestive that 980 nm diode laser is a novel technology for laser prostectomy, but in terms of surgical outcome, evidence is still sparse. Hundred patients were included in this study who underwent diode laser PVP and significant improvements in mean IPSS, Qmax & PVR were observed, and results are comparable to the similar case series ( Table 5 ) [ 24 25 28 ]. In recent years a few clinical trials with different techniques of diode laser enucleation have been reported [ 29 30 ], comparing diode laser enucleation of the prostate with bipolar TURP and reported equal improvement in functional outcomes with shorter hospital stay and catheterization time in patients who were treated with diode laser enucleation.…”

“…Therefore, there is no need to discontinue anticoagulant therapy before procedure [ 12 ]. In the diode laser at 980 nm, the speed of vaporization does not depend on the tissue being mucosa or fibromuscular stroma, which is not the case with other lasers [ 24 25 ]. Furthermore, diode laser also has the advantage of lower energy consumption and does not require high voltage connection, improving mobility of the laser generator, as compared to KPT and Ho: YAG laser devices [ 26 27 ].…”

Simulador de realidad virtual para el entrenamiento en vaporización fotoselectiva de la próstata con láser de diodo 980nm y curva de aprendizaje de la técnica

“…Actualmente la técnica de ablación con láser de diodo de 980 nm de alto poder con fibra de disparo lateral ha evolucionado progresivamente hacia una nueva aplicación con fibra de láser de contacto con cabeza de cuarzo ----conocida también como Twister----mejorando su resistencia a la degradación y la tasa de ablación de tejido 11,12 . Esta reciente tecnología ha demostrado un elevado poder terapéutico y buena seguridad a largo plazo 11,23,24 . Se necesitan estudios comparativos con RTUP y otras modalidades de láser, pero la vaporización fotoselectiva con láser de diodo supone actualmente un excelente elemento terapéutico para la HPB sintomática, especialmente en el grupo cada vez más frecuente de pacientes que toman medicación antiagregante.…”

Vaporization techniques for benign prostatic obstruction

“…The main advantage of the diode laser is a strong penetration depth with deep tissue coagulation up to 6.1 mm [17]. In contrast, two cohort studies evaluating the efficacy of the diode laser vaporization reported good perioperative and functional results, claiming mild dysuria as the only disadvantage [20,21]. The first studies compared 980-nm diode laser with the HPS GreenLight laser on the vaporization of the prostate in two nonrandomized single-center prospective studies [18,19].…”