Technique and results of interstitial laser coagulation
Abstract
By use of thermal "ablation" techniques to apply heat to the prostate from the urethra, the coagulation volume is limited by the limited penetration depth of suitable radiation sources, e.g., lasers, and by heat conduction. Secondarily, the coagulated tissue is removed by sloughing. Interstitial heat application was expected to overcome these problems. Our initial in vitro and animal studies using different light guides for interstitial Nd:YAG laser radiation showed that small, carbonized lesions were created by bare fibers, whereas large, homogeneous coagulation zones measuring up to 2 cm in diameter were produced by specially designed ITT (interstitial thermotherapy) fibers, which secondarily resulted in marked volume reduction by atrophy. Further experiments using such applicators resulted in an operation technique suitable for clinical routine in the treatment of symptomatic benign prostatic hyperplasia (BPH). These laser applicators are inserted into the prostate either transurethrally through a cystoscope under direct vision or percutaneously from the perineum under transrectal ultrasound guidance. The number of placements depends on the size and configuration of the gland. Radiation parameters were optimized for each sys...Continue Reading
Citations
Interstitial laser coagulation for management of benign prostatic hyperplasia: a Japanese experience
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