MORPHOLOGICAL AND MRI CHANGES IN HUMAN PR OSTATE ADENOMA FOLLOWING NEODYNAMIUM-YAG LASER-ABLATION

Minimally invasive procedures of the benign prostatic hyperplasia (BPH ) are being widely discussed at present among urologists. The transure thral laser coagulation under vision (VLAP) using Nd: YAG laser is the prominent procedure up to now In this paper we aimed at examining the histo-morphological and the MRI-changes in human prostate adenoma fol lowing such a laser therapy as well the results in dependence of time. We had as a total 4 patients being treated with a visual laser ablati on of 40 watts during 90 seconds at the 2, 4, 8 and 10 o'clock positio ns whose prostate was totally removed at intervals of 3,5 hours up to 9 days to be morphologically examined afterwards. With 3 patients ther e was carried out a contrast intrarectal-MRI 12 up to 24 hours prior t o prostatectomy. Morphological examination revealed periurethrally nec rotic areas of different extension, which were accompanied by haemorrh ages and partially obliterated vessels particularly in the periphery. The T-1- weighted contrast enhanced images were best suited for assess ment of laser-induced changes. The central necrotic tissue remained hy pointense following contrast administration, whereas the peripheral zo ne presented hyperintense compared to the adjacent unaffected glandula r tissue. In our experience we observed distinct differences compared to previous experimental studies with regard to extension and time cou rse of the necrotic areas.