Laser prostatectomy

抄録

Laser prostatectomy by contact-dragging irradiation using Ultraline^TM, side-firing laser fiber, and Nd: YAG laser was performed in 121 patients with BPH between August 1993 and July 1996. The total irradiation energy ranged from 18,147 to 365,185 (mean: 129,179) joules. The operation time ranged from 17 to 175 (mean: 77.8) minutes. It required 5.5 days on average until the patients became catheter-free after operation. As postoperative complications, urethral stricture occurred in 13 patients, epididymitis in 8, and postoperative hemorrhage in 1. Formation of cavity in the prostatic urethra by means of vaporization during operation improved dysuria early after operation and reduced a prostate volume by 31.1% through sloughing of coagulation layer within several weeks after operation, enabling maintenance of a good urination status over 2 years after operation. Since total irradiation energy was large (3,539 J/ml prostate) in the present method, transurethral ultrasonography (TUUS) was employed to ensure safe operation and to evaluate the results of operation. The present operation enabled channeling similar to that achieved by conventional TUR-P and complete removal of the transition zone of the prostate of 30ml or small. Postoperative complications, however, frequently occurred considered to be due to elongated operation time, thus it was considered to be the limit of vaporization method using Nd: YAG laser at present.