Quartz head contact laser fiber: a novel fiber for laser ablation of the prostate using the 980 nm high power diode laser.

PURPOSE: High power 980 nm diode laser ablation of the prostate using the side firing fiber has proven its efficiency and safety in treating lower urinary tract symptoms secondary to benign prostatic hyperplasia. Nevertheless, this procedure is associated with some drawbacks such as prolonged irritative symptoms and tissue sloughing. In this study we evaluated the clinical outcome of high power 980 nm diode laser ablation of the prostate using a new quartz head contact fiber, and compared it to the standard side firing fiber in a randomized fashion. MATERIALS AND METHODS: A total of 120 patients with benign prostatic hyperplasia scheduled for high power 980 nm diode laser ablation of the prostate were randomized to receive treatment with the standard side firing fiber or the novel quartz head contact fiber between April 2009 and April 2010. Patients were followed for at least 6 months, although 7 were lost to followup. RESULTS: The side firing fiber and quartz head contact fiber groups demonstrated significant improvement in International Prostate Symptom Score (from 20 to 8.39 vs 21.63 to 9.91), International Prostate Symptom Score-quality of life (from 4.47 to 1.94 vs 4.57 to 1.98) and maximum flow rate (from 7.79 to 22.22 vs 8.93 to 29.63 ml per second), and decreased prostate volume (47.79% vs 55.54%) and prostate specific antigen (59.69% to 60.61%), respectively. Complications, postoperative passage of tissue remnants and irritative symptoms were significantly less in the quartz head contact fiber group, as was the number of fibers per case. CONCLUSIONS: The quartz head contact fiber can produce similarly good outcomes in ablating the prostate using the high power 980 nm diode laser compared to the side firing fiber, and with fewer complications and side effects.

Safety and efficacy of quartz head contact laser ablation for large prostates using 980-nm laser: a comparative prospective study against that for small- and medium-sized prostates.

OBJECTIVE: To examine the safety and efficacy of quartz head laser ablation of the prostate (QLAP) in the treatment of large and huge prostates as compared with small- and medium-sized ones. MATERIALS AND METHODS: Two hundred forty-two patients with lower urinary tract symptoms secondary to benign prostatic hypertrophy (BPH) were included in the study, of which 210 patients were evaluable. Patients were divided into 2 groups: group A: patients with BPH volume of <80 mL (120 patients) and group B patients with gland size ≥80 mL. All patients were subjected to QLAP procedure. They were evaluated perioperatively and 1 week; 1, 3, and 6 months; and every 6 months thereafter postoperatively. RESULTS: Patients' demographics and preoperative data were similar except for the gland size (group A, 54.96 ± 15.49 mL [20-79 mL] and group B, 124.68 ± 40.88 mL [80-233 mL]). Operative time corrected to gland volume was shorter in group B. Only 10% of all patients needed 2 fibers. There was no significant electrolyte change in both groups. Hemoglobin has minimally decreased in both groups but was statistically significant. Group B outcome was significantly better regarding International Prostate Symptom Score, International Prostate Symptom Score quality of life, and uroflowmetry. Prostate size decreased by 47 ± 2% and 62.7 ± 2% at 6 months post operatively for groups A and B, respectively. CONCLUSION: QLAP demonstrated good efficacy and safety in treating large and huge BPH. It possessed no added risk as compared with small prostates. It can be a good alternative to open prostatectomy especially in patients with significant comorbidities.