BPH 06. "Sliced" vaporesection with 2 μm laser in the treatment of benign prostatic hyperplasia

Objective: To study the efficacy of vaporesection of prostate gland with 2 μm laser in the treatment of benign prostatic hyperplasia (BPH).

Methods: 210 patients with benign prostatic hyperplasia were treated with the 70 W RevoLix laser for BPH by the same operator to resect three lobes of gland: every lobe was bluntly sepatated and excised into clusted. Then clusted gland tissue was "sliced" with the lateral movement of the device.

Results: The operation time was 35-140 min, and the average time was (62±19) min. There were 6 cases of intraoperative blood transfusion, the mean volume of transfusion was 250 mL. The duration of postoperative catheterization was 1-6 d, the average time was (2.5±1.8) d. The length of hospital stay was 4-7 d, and the average was (4.5±1.2) d. 3 cases of postoperative urethral stricture were observed, and emiction was improved after discontinuous dilation of the urethra was performed. Postoperative follow-up lasted 3 to 6 months, the mean maximum flow rate before and after operation was (6.8±2.5) mL/s and (18.5±3.6) mL/s; residual urine was (149.4±70.2) mL/s and (23±6.8) mL/s respectively; the international prostate symptom score was 22.4±5.5 and 5.3±3.2; and the life quality score was 4.8±0.8 and 1.6±1.1. The differences between the four indicators before and after operation were statistically significant (P<0.01).

Conclusions: The whole lobe of gland can be separated from capsule when the gland is in cluster without repeated confirmation and isolation of surgical capsule. The "sliced" resection is far away from seminal colliculus and the capsule of prostate thus the resection of the gland can be accelerated and the risk of cutting through the capsule is avoided at the same time. The "sliced" resection. The characteristics of lateral motion of 2 μm laser is brought into full play in the "sliced" resection. Vaporized resection of the prostate is easy to cleave clustered tissue that can shorten learning curve and improve the efficiency of resection. The most blood supply of clustered gland was cut off from the base of capsule at first thus decreases immediately that makes less bleeding and clear field of operation. "sliced" dvaporesection with 2 μm laser in the treatment of BPH is an safe and effective operative method.