ABSTRACT
Introduction 158
Historical Background 158
Laser-Tissue Interactions 159
Lasers used in Prostatectomy 160
Neodymium:YAG Laser 160
KTP (Potassium Titanyl Phosphate) Laser 160
Holmium:YAG Laser 160
Laser Coagulation of the Prostate 161
Free Beam, Noncontact Laser Coagulation of the Prostate 161
TULIP (Transurethral Ultrasound-Guided
Laser-Induced Prostatectomy) 161
Endoscopic Laser Ablation of the Prostate 162
Interstitial Laser Coagulation of the Prostate 164
Laser Prostatectomy by Vaporization 166
Contact Laser Vaporization of the Prostate 167
KTP Laser Vaporization of the Prostate 168
Hybrid Laser Techniques 169
Holmium:YAG Laser Prostatectomy 170
Conclusions 173
References 174
INTRODUCTION
Transurethral resection of the prostate (TURP) has rightly gained the mantel of
the “gold standard” surgical option for the treatment of bladder outflow obstruc-
tion (BOO) secondary to benign prostatic hyperplasia (BPH). However, the mor-
bidity of the procedure has led to the search for more minimally invasive
alternatives with similar efficacy but lower side-effect profiles. There has been
an explosion of interest in the use of numerous forms of energy to induce
thermal damage to the prostate with the hope of relieving BOO. Radio and micro-
waves, high-intensity focused ultrasound, and new electrosurgical appliances are
discussed elsewhere in this book, but this chapter will concentrate on the use of
lasers.
