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Diode laser (980 nm) enucleation of the prostate: a promising alternative to transurethral resection of the prostate

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Abstract

With good hemostatic ability, the end-firing continuous-wave diode laser at 980 nm was used to enucleate the prostate (DiLEP) for the treatment of benign prostatic obstruction (BPO). The study compared the patients’ demographics and surgical outcomes between DiLEP and transurethral resection of the prostate (TURP). Patients with significant BPO and a total prostatic weight of 40 g or more who had undergone DiLEP (n = 74) or TURP (n = 52) during the same period at our hospital were enrolled for analysis. DiLEP was performed by a single surgeon (Yang), and TURP by three surgeons (Yang, Hsieh and Chang). The 4-U incision technique was developed for DiLEP. The diode laser ensured bloodless incision followed by blunt dissection using the resectoscope and laser fiber as an 'index finger' to enucleate the prostate. To prevent unexpected deep thermal damage, the power of the laser was set at 80 W and the laser beam was directed towards the bladder neck and not towards the prostatic capsule. Demographic data and perioperative parameters were comparable between the two groups, except that DiLEP resulted in a significantly lower drop in hemoglobin level (0.9 ± 1.0 vs. 1.6 ± 2.4 g/dl, p = 0.03), shorter catheterization time (41.2 ± 19.9 vs. 67.7 ± 33.3 h, p = 0.01), and shorter postoperative stay (2.9 ± 1.9 vs. 4.1 ± 6.2 days, p = 00.01). Delayed postoperative sloughing of necrotic tissue was not observed in the DiLEP group. Improvements in voiding parameters were comparable between the groups, and were sustained during a follow-up of up to 1 year. DiLEP provided better hemostasis than TURP as evidenced by less blood loss. The role of DiLEP treating BPO requires further investigation.

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Authors and Affiliations

  1. Division of Urology, Department of Surgery, Buddhist Tzu Chi General Hospital, Taipei Branch, 289, Jianguo Road, Xindian, New Taipei, Taiwan

    Stephen S. Yang, Cheng-Hsing Hsieh & Shang-Jen Chang

  2. Department of Pathology, Buddhist Tzu Chi General Hospital, Taipei Branch, Xindian, New Taipei, Taiwan

    Yi-Shin Lee

  3. Department of Urology, School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan

    Stephen S. Yang, Cheng-Hsing Hsieh & Shang-Jen Chang

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  1. Stephen S. Yang
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  2. Cheng-Hsing Hsieh
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  3. Yi-Shin Lee
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  4. Shang-Jen Chang
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Correspondence to Shang-Jen Chang.

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Yang, S.S., Hsieh, CH., Lee, YS. et al. Diode laser (980 nm) enucleation of the prostate: a promising alternative to transurethral resection of the prostate. Lasers Med Sci 28, 353–360 (2013). https://doi.org/10.1007/s10103-011-1046-3

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  • DOI: https://doi.org/10.1007/s10103-011-1046-3

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