Volume 55, Issue 2, Pages (February 2009)

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Presentation transcript:

Volume 55, Issue 2, Pages 368-375 (February 2009) Endoscopic Vaporesection of the Prostate Using the Continuous-Wave 2-μm Thulium Laser: Outcome and Demonstration of the Surgical Technique Roman Szlauer, Robert Götschl, Aria Razmaria, Ljiljana Paras, Nikolaus T. Schmeller European Urology Volume 55, Issue 2, Pages 368-375 (February 2009) DOI: 10.1016/j.eururo.2008.10.034 Copyright © 2008 European Association of Urology Terms and Conditions

Fig. 1 Wavelength and water absorption coefficient of the 2.013-μm Tm:YAG laser compared with the Ho:YAG, Nd:YAG, and CO2 lasers (courtesy of LISA laser products, Germany). Tm:YAG=thulium-doped yttrium aluminium garnet; Ho:YAG=holmium-doped yttrium aluminium garnet; Nd:YAG=neodymium-doped yttrium aluminium garnet. European Urology 2009 55, 368-375DOI: (10.1016/j.eururo.2008.10.034) Copyright © 2008 European Association of Urology Terms and Conditions

Fig. 2 Resected prostate tissue for histologic evaluation. The resected tissue chips are small enough to be washed out by the standard 24F resectoscope. The thin coagulation rim of necrotic tissue of <1mm does not interfere with adequate histologic diagnosis. European Urology 2009 55, 368-375DOI: (10.1016/j.eururo.2008.10.034) Copyright © 2008 European Association of Urology Terms and Conditions

Fig. 3 Exemplary preoperative transrectal ultrasound of a prostate. The measured approximate volume by transrectal ultrasound (length×width×depth÷2) is 55cm3, and the preoperative prostate-specific antigen value is 4.89 ng/ml. European Urology 2009 55, 368-375DOI: (10.1016/j.eururo.2008.10.034) Copyright © 2008 European Association of Urology Terms and Conditions

Fig. 4 Exemplary postoperative transrectal ultrasound of the prostate of the same patient as shown in Fig. 3. The measured approximate prostate volume (length×width×depth÷2) 2 mo after vaporesection is 18cm3, and the prostate-specific antigen value decreased to 1.72ng/ml. The measured volume reduction of 65% corresponds well to a prostate-specific antigen decrease of 67% in this particular patient. The resected channel can be well identified all through the prostatic urethra. European Urology 2009 55, 368-375DOI: (10.1016/j.eururo.2008.10.034) Copyright © 2008 European Association of Urology Terms and Conditions