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

Urol Int. 2013;91(4):391-6. doi: 10.1159/000353554. Epub 2013 Oct 2.

Abstract

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).

Methods: 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.

Results: 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.

Conclusions: 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.

MeSH terms

  • 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*