Nd: YAG laser thermocoagulation of the prostate: the barbecue effect.

OBJECTIVE: To determine systematically the depth of coagulation necrosis induced during Nd: YAG laser irradiation in the canine prostate model, and to define the correlation of laser dose with depth of the lesions. METHODS: We investigated the effect of various dosimetries on prostatic tissue of 17 mongrel canines using laser power in the range of 8 to 60 watts (W) at varying exposure times, from 20 to 300 seconds (S). Applied energy ranged from 1,000 to 5,500 Joules (J). RESULTS: Three distinct features were observed. First, deep coagulation necrosis was induced only with laser regimens of > or = 2,100J, suggesting that there is a threshold of energy that must be overcome in order to achieve significant coagulation depth. Second, the deepest coagulation necrosis was achieved with a low power slow-heating regimen (15W X 180S). Tissue surface changes appeared to be responsible for the reduced depth of coagulation necrosis seen with higher power regimens (> 20 W). Third, increasing the energy above 3,600J did not augment the depth of coagulation, suggesting that a steady state for temperature distribution is reached at that rate of heating. CONCLUSIONS: Our study suggests that in the canine prostate, a low power slow-heating regimen of 15W X 180S may yield larger volumes of coagulation necrosis than other regimens.