Preliminary results on selective light vaporization with the side-firing 980 nm diode laser in benign prostatic hyperplasia: an ejaculation sparing technique

Abstract

This study examined efficacy and safety of the 980 nm side-firing diode laser operating at a power of 100 W in patients with lower urinary tract symptoms associated with benign prostatic hyperplasia (BPH). Patients were selected for surgery on the basis of maximum urinary flow rate (Qmax) p15 ml/s or transvesically measured post-voiding residual volume (PVR) 4100 ml in conjunction with an International Prostate Symptom Score (IPSS) 47. Laser therapy was conducted under spinal anaesthesia. Qmax, IPSS, prostate volume, PVR, IPSS-Quality of Life (QoL) questionnaire and ejaculatory function were measured at baseline and at 1, 3, 6 and 12 months post-laser therapy. A total of 52 consecutive patients aged 52-65 years with mean (s.d.) prostate volume of 45.14 (9.15) g were treated. All patients were able to leave the hospital at a mean (s.d.) of 5 (2) h after the procedure. Mean (s.d.) follow-up was 100 (75.49) days. A significant reduction in IPPS was reported at 1 month (Po0.0001) and this was maintained through to 6 months. Significant durable improvements in Qmax, PVR and IPSS-QoL score were also reported for all patients (Po0.0001). No severe complications were reported, including any cases of urinary incontinence or significant irritative symptoms. None of the patients complained of a worsening of erectile function. This early experience in a pilot study with the 980 nm diode laser seems promising in the short-term and long-term outcome is being monitored.

Diode Laser (980 nm) Vaporization in Comparison With Transurethral Resection of the Prostate for Benign Prostatic Hyperplasia: Randomized Clinical Trial With 2-year Follow-up

“…Recent published literature on efficacy of diode laser vaporization showed a significant improvement of functional outcomes during the first year of follow-up. 15,16,19 In a 24-month follow-up study, Lee et al reported decrease of peak flow rate after 1 year from the procedure. 26 In a recent study, diode laser ablation achieved significant improvements in functional outcomes during the follow-up of 24 months when combined with bipolar TURP.…”

Current Laser Treatments for Benign Prostatic Hyperplasia

“…There are only few clinical pilot studies for the vaporization of the prostate using diode lasers. Two series used 980 nm diode lasers of different manufacturers [71,72] and one used a 1,470 nm diode laser prototype [71]. Complication rates were low and the authors reported low or no perioperative bleeding.…”

Holmium laser enucleation of the prostate: patient selection and perspectives

“…One study aimed to improve the rate of retrograde ejaculation following HoLEP by sparing the ejaculatory hood, defined as the paracollicular and supracollicular tissue >1 cm proximal to the veru montanum 60. This ejaculatory hood sparing technique has been shown to work for TURP61 and laser vaporization of the prostate, with a 92% rate of antegrade ejaculation preservation 62…”