Aj. Costello et al., HISTOPATHOLOGICAL CHANGES IN HUMAN PROSTATIC ADENOMA FOLLOWING NEODYMIUM-YAG LASER-ABLATION THERAPY, The Journal of urology, 152(5), 1994, pp. 1526-1529
Transurethral laser ablation of the prostate is a procedure currently
under evaluation as an alternative to transurethral resection of the p
rostate in the management of benign prostatic hyperplasia. Removal of
prostatic tissue by endoscopic resection or open surgical techniques f
rom 7 patients in whom prostatic laser ablation was previously attempt
ed offered an opportunity to evaluate the sequential effects of such e
nergy upon the human prostate at varying intervals after treatment. A
progressive inflammatory and necrotic response, initially akin to that
demonstrated after a thermal burn, together with evolving vascular ch
anges within the residual viable prostatic tissue were demonstrated. O
ur study demonstrates the changes in the human prostate whereby neodym
ium:YAG laser energy causes a deep coagulative necrosis and arterial t
hrombosis in the prostatic adenoma. These changes differ significantly
from those noted in canine studies. A slower cavitation effect is obs
erved in the human compared with the canine, and this finding mirrors
the continuing clinical improvement in voiding parameters with time.