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Proceedings Paper

Hi-tech of the prostate: interstitial laser coagulation of benign prostatic hypertrophy
Author(s): Rolf Muschter M.D.; Alfons G. Hofstetter; Stefan Frank F. Hessel; Ernst Keiditsch; Karl-Heinz Rothenberger; Peter Schneede; Klaus H. Frank
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Paper Abstract

We report on the new technique of interstitial laser coagulation of the prostate (ILCP) in the treatment of benign prostatic hyperplasia (BPH). Basic experiments by use of a Nd:YAG laser in combination with a newly designed fiber tip homogeneously distributing the laser irradiation have been performed in potato, muscle, liver, and surgically removed human BPH-tissue to determine the volume of coagulation. The coagulation zone surrounding the probe was well defined and homogeneous. The size was dependent on laser power and irradiation time. Carbonization was never present except in darker tissues irradiated with high energy. Volume and time resolved measurements correlated well with the size of coagulation. 10 W and 5 minutes, for example, resulted in a coagulation zone of 17 X 15 mm. Comparable results have been seen in in-vivo experiments in surgically exposed canine prostates. Specimen for macroscopic and microscopic examination were taken immediately after treatment and after 5 and 35 days. The well demarked coagulation necrosis of the early stage resulted in cystic degeneration and fibrosis in the later stages. This was combined with shrinkage and reduction in volume. The urothelium of the urethra, the external sphincter and the rectum showed no damage. Until now, 15 patients suffering from obstructive symptoms due to BPH have been treated with interstitial laser coagulation. The probes were inserted from the perineum into the center of each lateral lobe of the prostate by transrectal ultrasound guidance, while the median lobe was treated by urethroscopic guidance, while the median lobe was treated by urethroscopic control. Dependent on the size of the prostate irradiation, time was 5 to 10 minutes per lobe at a power setting of 5 to 10 W.

Paper Details

Date Published: 1 June 1992
PDF: 10 pages
Proc. SPIE 1643, Laser Surgery: Advanced Characterization, Therapeutics, and Systems III, (1 June 1992); doi: 10.1117/12.137385
Show Author Affiliations
Rolf Muschter M.D., Munich Univ. (Germany)
Alfons G. Hofstetter, Munich Univ. (Germany)
Stefan Frank F. Hessel, MBB Medizintechnik GmbH (Germany)
Ernst Keiditsch, Bogenhausen Hospital (Germany)
Karl-Heinz Rothenberger, Landshut Hospital (Germany)
Peter Schneede, Munich Univ. (Germany)
Klaus H. Frank, Bodenseewerk Geraetetechnik GmbH (United States)

Published in SPIE Proceedings Vol. 1643:
Laser Surgery: Advanced Characterization, Therapeutics, and Systems III
R. Rox Anderson M.D., Editor(s)

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