VISUAL LASER-ABLATION OF THE CANINE PROSTATE WITH A DIFFUSING FIBER AND AN 805-NANOMETER DIODE-LASER

Background and Objective: Although the popularity of visual laser abla tion of the prostate (VLAP) as a treatment for symptomatic, benign pro static hyperplasia (BPH) is increasing, the perceived advantages of VL AP over conventional transurethral electroresection of the prostate (T URF) is being debated because optimal technique and dosimetry for surg ical lasers are still being refined. At this time, the 1.06 neodymium: yttrium-aluminum-garnet (Nd:YAG) laser and a laterally deflecting deli very system is the hardware combination most widely used for VLAP. Stu dy Design/Materials and Methods: Reported here is a study of an altern ate system, a 805-nm diode laser (Diomed 25(R) Diomedics, The Woodland s, TX) with a cylindrically diffusing fiber (Surgimedics Inc., The Woo dlands, TX). Eight mongrel dogs were prostatectomized by transurethral irradiation of the prostate with 15,000 J of diode laser energy deliv ered via a fiber that diffuses the energy in a 1.5-cm-long cylindrical pattern. The dogs were sacrificed and prostates harvested at 3 hours and 1, 4, 7, 14, 21, 35, and 49 days after the procedure, fixed with 1 0% buffered formalin, and examined histologically. Results/Conclusions : It was found that this laser/fiber combination created volumes of ti ssue coagulation similar to those encountered in our previous work wit h the Nd:YAG laser in combination with both laterally deflecting and d iffuser fibers, while offering the distinct advantages of simplified t echnique, lower cost hardware, and fewer postoperative complications i n the dog model. (C) 1996 Wiley-Liss, Inc.