Diode lasers for interstitial laser coagulation of the prostate

Rolf Muschter M.D.; Aaron P. Perlmutter M.D.; K. Anson; P. Jahnen; Juan C. Vargas Stuve; Hassan A. Razvi; Ronald Sroka; Alfons G. Hofstetter; Darracott E. Vaughan Jr.

doi:10.1117/12.209073

12 May 1995 Diode lasers for interstitial laser coagulation of the prostate

Rolf Muschter M.D., Aaron P. Perlmutter M.D., K. Anson, P. Jahnen, Juan C. Vargas Stuve, Hassan A. Razvi, Ronald Sroka, Alfons G. Hofstetter, Darracott E. Vaughan Jr.

Author Affiliations +

Proceedings Volume 2395, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems V; (1995) https://doi.org/10.1117/12.209073
Event: Photonics West '95, 1995, San Jose, CA, United States

Abstract

The concept of interstitial laser coagulation (ILC) of the prostate is the generation of intraprostatic lesions of large volumes, which secondarily are resorbed. In previously published experimental and clinical studies Nd:YAG lasers in combination with specially designed light guides were used. The aim of this study was to examine the suitability of diode lasers to be used in ILC. Diode lasers of various wavelengths (805 nm, 830 nm, 950 nm and 980 nm) with different interstitial applicators (predominantly diffusor tips) were tested in vitro (potatoes, turkey muscle, porcine liver) and in vivo (canine prostate). In vitro experiments were done with various powers and radiation times in order to evaluate the maximum lesion size achievable without tissue carbonization. This depended on the length of the applicator and could measure more than 20 mm. To get large lesion volumes with short radiation times, but to avoid charring, in vivo graded powers were favorable. These were optimized for some systems. In the canine prostate, lesion diameters of up to 15 mm were achieved. For clinical use, interstitial applicators were inserted into the bulky BPH transurethrally through a cystoscope under direct vision, either directly or aided by an introducer system. The number of fiber placements depended on the size and configuration of the gland and varied between 3 and 16. With the 980 nm diode laser and an applicator with conical beam pattern, irradiation was performed for 3 minutes per fiber placement using stepwise reduced power (20 W for 30 s, 15 W for 30 s, 10 W for 30 s and 7 W for 90 s). With the 830 nm diode laser and diffusor tip, the initial power of 10 W was reduced to 5 W within 4 minutes total radiation time. From 1993, 19 patients were treated with diode lasers (830 and 980 nm). Three months follow-up in 15 patients treated with 830 nm showed an AUA-score change from 18.9 to 5.9 and a peak flow rate change from 7.8 to 15.2 ml/s.

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Rolf Muschter M.D., Aaron P. Perlmutter M.D., K. Anson, P. Jahnen, Juan C. Vargas Stuve, Hassan A. Razvi, Ronald Sroka, Alfons G. Hofstetter, and Darracott E. Vaughan Jr. "Diode lasers for interstitial laser coagulation of the prostate", Proc. SPIE 2395, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems V, (12 May 1995); https://doi.org/10.1117/12.209073

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