HOLMIUM-YTTRIUM-ALUMINUM-GARNET LASER PROSTATECTOMY

ris alternatives to transurethral resection of the prostate for treatm ent of benign prostatic hyperplasia, various types of laser prostatect omy-most notably, neodymium:yttrium-aluminum-garnet (YAG) and potassiu m titanyl phosphate laser procedures-have proved to be associated with considerably less morbidity (for example, bleeding, need for transfus ion, intraoperative fluid absorption, and postoperative incontinence), Despite these advantages, certain disadvantages (need for prolonged p ostoperative catheterization and delayed symptomatic improvement) prom pted investigation of the holmium:YAG laser for performance of prostat ectomy, The holmium:YAG laser is highly absorbed by tissue water and c auses rapid vaporization of ex-posed soft tissue. After initial studie s in canine prostates and human prostatectomy specimens, clinical stud ies with the holmium:YAG laser showed no fluid absorption, appreciable blood loss, or complications, and voiding outcomes mere improved imme diately, similar to the result with transurethral resection of the pro state. In addition, the holmium:YAG laser has been used to perform tra nsurethral incision of the prostate rapidly and hemostatically. Holmiu m laser resection of the prostate is a safe and efficacious procedure for relief of symptomatic bladder outlet obstruction due to benign pro static hyperplasia.