Basic Principles of Laser for Prostate Surgery

Abstract

Recent advances in laser technology have provided a varied arsenal for endoscopic treatment of benign prostatic hyperplasia. Laser is a collimated coherent radiation of photons generated by stimulated emission of gain media, allowing transfer of selective, controlled and focused energy to the targeted tissue. The application of laser to prostate surgery developed hand-in-hand with refinements to the equipment. Earlier lasers were low powered modalities with no significant tissue selectivity, aimed at thermal coagulation and resulted in significant side effects and recurrence. Since then, prostate lasers have developed towards a more high-powered and selective modality that allowed complete ablation of the tissue with fewer complications. Fiber technology has also developed to allow efficient and safe transfer of a continuously increasing energy output. It is important for the surgeon to understand these fundamental principles of laser and prostate surgery, not only to select the proper tools, but also to properly implement the technique as well.