Histopathological Evaluation of Laser Thermocoagulation in the Human Prostate: Optimization of Laser Irradiation for Benign Prostatic Hyperplasia

Eduardo Orihuela, Massoud Motamedi, Mariela Pow-Sang, Marcellus LaHaye, Daniel F. Cowan, Michael M. Warren

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

We have previously shown in a canine prostate model that a noncontact low power neodymium: YAG laser regimen of 15 watts for 180 seconds yields a larger volume of coagulation necrosis than the currently recommended high power regimen of 50 watts for 60 seconds. These 2 regimens have not yet been compared in humans. The objective of this study was to evaluate histopathologically the thermocoagulation effect of these 2 laser regimens in the human prostate and the effect of the spatial distribution of the laser lesions on the extent of coagulation necrosis. The study was conducted in 10 patients undergoing radical prostatectomy or cystoprostatectomy. The laser treatment was given transurethrally 1 hour before removal of the specimen. There were no fractures of the prostate. The coagulation necrosis did not reach the peripheral zone and it was minimal in areas rich in fibromuscular tissue, such as the bladder neck. At times, nodular benign prostatic hyperplasia was unaffected. A 4-quadrant treatment in the same plane often yielded small nonconfluent lesions. Confluent lesions in the same plane yielded approximately 30 percent greater depth of coagulation necrosis, which was achieved when 3 or 4 lesions were created on each side of the prostate (per single transverse plane). Likewise, coagulation necrosis observed with 15 watts for 180 seconds was approximately 40 percent greater than that noted with the 50 watts for 60 seconds regimen. Our findings suggest that noncontact laser prostatectomy is a safe procedure that can be improved by modifying the laser regimen and the spatial distribution of lesions.

Original languageEnglish (US)
Pages (from-to)1531-1536
Number of pages6
JournalThe Journal of Urology
Volume153
Issue number5
DOIs
StatePublished - 1995

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Laser Coagulation
Prostatic Hyperplasia
Prostate
Lasers
Necrosis
Prostatectomy
Neodymium
Electrocoagulation
Solid-State Lasers
Canidae
Urinary Bladder
Therapeutics

ASJC Scopus subject areas

  • Urology

Cite this

Histopathological Evaluation of Laser Thermocoagulation in the Human Prostate : Optimization of Laser Irradiation for Benign Prostatic Hyperplasia. / Orihuela, Eduardo; Motamedi, Massoud; Pow-Sang, Mariela; LaHaye, Marcellus; Cowan, Daniel F.; Warren, Michael M.

In: The Journal of Urology, Vol. 153, No. 5, 1995, p. 1531-1536.

Research output: Contribution to journalArticle

Orihuela, Eduardo ; Motamedi, Massoud ; Pow-Sang, Mariela ; LaHaye, Marcellus ; Cowan, Daniel F. ; Warren, Michael M. / Histopathological Evaluation of Laser Thermocoagulation in the Human Prostate : Optimization of Laser Irradiation for Benign Prostatic Hyperplasia. In: The Journal of Urology. 1995 ; Vol. 153, No. 5. pp. 1531-1536.
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