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Histomorphological changes after neodymium: YAG laser-coagulation of the human prostate with the Side Focus fiber : Effect of power setting and time

Sulser, T. ; Jochum, W. ; Heitz, P. ; Hauri, D.

In: Urological Research, 1997, vol. 25, p. S7-S12

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    Title
    • Histomorphological changes after neodymium: YAG laser-coagulation of the human prostate with the Side Focus fiber
      Effect of power setting and time
    Author
    • Sulser, T.. Department of Urology, University Hospital Zurich, CH-8091, Zurich, Switzerland
    • Jochum, W.. Department of Pathology, Institute of Clinical Pathology, University Hospital Zurich, CH-8091, Zurich, Switzerland
    • Heitz, P.. Department of Pathology, Institute of Clinical Pathology, University Hospital Zurich, CH-8091, Zurich, Switzerland
    • Hauri, D.. Department of Urology, University Hospital Zurich, CH-8091, Zurich, Switzerland
    Document Type
    • Postprint
    OAI-PMH Identifier
    • oai:doc.rero.ch:314988
    Summary
    The objective of our study was to determine optimal treatment parameters and appropriate methods of examination for neodymium:yttrium-aluminum-garnet (Nd:YAG) high-power laser coagulation of the human prostate in relation to power setting and time. Transurethral free-beam laser coagulation was performed with the Side-Focus side-firing laser fiber in ten patients prior to planned radical surgery, of whom six underwent transperitoneal laparoscopic lymphadenectomy and laser coagulation 4-9 days prior to open surgery. Depth and volume of coagulated prostatic tissue were measured at power setting/time combinations of 40 W/90 s and 60 W/60 s, respectively, while holding total energy delivery constant. Microscopic examination in the early phase showed that epithelial cells had become loose from the basal-cell membrane. By 4-9 days there was evidence of conspicuous squamous epithelial metaplasia with a high proliferation rate as a sign of reepithelialization. Using the Side Focus side-firing laser fiber, both treatment modalities showed comparable volume coagulation. In contrast there was a significant difference between those prostates removed at 4-9 days and those removed at 60-210 min after laser coagulation. We conclude that laser-induced changes in the human prostate are conclusively discernible only after 4 days