Enucleation of the Prostate for the Treatment of Benign Prostatic Hyperplasia Using a 980 nm Diode Laser

Here, we present a protocol for modified 980 nm diode laser enucleation to treat large volume benign prostatic hyperplasia.

In the aging male population, the occurrence of lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) is a common problem. Here, we introduce a new technique called 980 nm diode laser enucleation (DiLEP) to treat BPH¹. Diode lasers can absorb both water and hemoglobin at the same time, so they are good for cutting and hemostasis². The diode laser was approved by the FDA in 2007, and has been used in the treatment of BPH because of its effective cutting and hemostasis effect³. DiLEP presents several advantages over other techniques, such as TURP, HoLEP, and PVP. During the procedure, we define the boundary of a high-volume prostate and separate it into three lobes with a diode laser by burning two rings and one groove (like a Cupid's arrow). Compared to other procedures, mDiLEP has fewer intraoperative complications, a shorter learning curve, and achieves more tissue resection.

Compared with traditional transurethral resection of the prostate (TURP), laser surgeries have gradually become more popular due to their better patient tolerance, lower amounts of intraoperative blood loss, efficacy, and shorter postoperative recovery^4,5.

In recent years, the fastest growing techniques have involved the use of lasers of various wavelengths. At present, many types of lasers with different characteristics can be used to complete prostate enucleation. Since the diode laser was approved by the US FDA for prostatic hyperplasia in 2007, its use has gradually increased in....

All methods described here have been approved by ethics committee of Beijing Hospital. Indications for surgery are according to the European Association of Urology guidelines for nonneurogenic male LUTS. Contraindications include suspected prostate cancer or detrusor dysfunction.

1. Instruments for operation

1. Ensure the availability of diode laser (980 nm) equipment with a power including continuous mode (80-100 W).
2. Employ a laser fiber and 0.9% saline solution for intraop.......

A total of 40 patients with BPH who underwent DiLEP were included in one of our studies. An independent sample t-test was used as the statistical method. All patients successfully completed the operation. Almost all of the patients had the catheter removed within 5 days postoperative (Table 1). All patients returned to the hospital for follow-up examinations in the 1^st, 3^rd, and 12^th months postoperatively. The International Prostate Sympt.......

At present, the 980-mm diode laser is beginning to be used for the treatment of BPH⁵. Few reports have described related clinical studies. Compared to the effect of TURP in the treatment of BPH, many studies have shown that DiLEP causes less blood loss, achieves better urination function, and has shorter catheter retention times^9,13,14,15.

Her.......

The authors would like to acknowledge the support of the National Key Research and Development Program of China (Grant 2017YFC840102).